Ultrasound guided pulmonary artery catheter insertion: An alternative to fluoroscopic guidance

Enambir Josan; Nicholas Pastis; Ziad Shaman

doi:10.1016/j.rmcr.2022.101678

Ultrasound guided pulmonary artery catheter insertion: An alternative to fluoroscopic guidance

Respir Med Case Rep. 2022 May 25:38:101678. doi: 10.1016/j.rmcr.2022.101678. eCollection 2022.

Authors

Enambir Josan¹, Nicholas Pastis¹, Ziad Shaman²

Affiliations

¹ Division of Pulmonary Disease, Critical Care and Sleep Medicine, The Ohio State University Hospital, Columbus, OH, USA.
² Division of Pulmonary Disease, Critical Care and Sleep Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.

Abstract

Pulmonary artery catheters (PACs) can provide extremely valuable objective data in select patients. They are usually advanced by floatation of balloon tip along the normal blood flow and their placement is confirmed under pressure waveform guidance. Imaging such as fluoroscopy is often employed in low flow states and in cardiac catheterization suite to reduce the failure rate and time to wedge; but is not readily available at bedside. In critically ill patient, bedside insertion is feasible but can be complicated by repeated attempts to float the balloon tip through various cardiac chambers. Point of care ultrasound can be used to visualize the balloon tip of PAC inside the cardiac chambers alongside the confirmatory pressure waveform changes.

Keywords: POCUS; Pulmonary artery catheter; Pulmonary hypertension; Shock; Swan Ganz; Ultrasound.

Publication types

Case Reports