Catheter-Induced Delayed Recurrent Pulmonary Artery Hemorrhage

Abstract

INTRODUCTION of the flow-directed, balloon-tipped catheter by Swan et al¹in 1970 has facilitated bedside hemodynamic monitoring in the critically ill patient. Although this catheter usually allows safe measurement of important hemodynamic variables, it is not without morbidity.^2,3 Pulmonary artery hemorrhage is a relatively rare but often catastrophic complication of pulmonary artery catheterization. The literature reports an incidence of 0.06% to 0.2%,^4,5with a mortality ranging from 45% to 65%.^6-8Survivors, on rare occasion, exhibit delayed hemorrhage after stabilization from the initial bleeding episode. Only five cases of delayed recurrent pulmonary artery hemorrhage have been reported,^8-12with a delay of 33 hours to 7 months. Three of these patients survived; two required thoracotomy,^9,12and the other received therapeutic embolism to a false aneurysm of the pulmonary artery.¹⁰Presented are three additional patients who suffered recurrent delayed pulmonary hemorrhage secondary to balloon-tipped catheters, one