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Pulmonary Artery Catheterization

A pulmonary artery (PA) catheter (also referred to as the Swan-Ganz catheter) is a special catheter which is placed via a large central vein through the right-sided chambers of the heart (the right atrium and right ventricle) into the pulmonary artery. The catheter literally "floats" into the final position by use of a small balloon flotation device at its tip. As the catheter is advanced into its final position, the physician can follow its course through the chambers of the heart by watching the pressure waves on the bedside monitor.

balloon inflated in the final position, the catheter will "wedge" into a small branch of the pulmonary artery. The pressure measured during this wedging maneuver estimates the pressure in the left atrium and even the left ventricle during relaxation phase. In addition to the pressure measurements, the PA catheter can be used to measure the output (flow) from the heart (termed the cardiac output), and core temperature (the body temperature near the heart).

The physician utilizes information from the PA catheter to better understand the patient's critical illness. The catheter is especially helpful in shock-like states where there is multiple organ dysfunction (including heart, lungs, kidney and liver). In this case, the PA catheter may not only help the physician gain an understanding of the cause of the organ dysfunction but may also help guide therapy to improve the organ function.

Immediate complications of insertion of PA catheters include bleeding, arrhythmias (irregular heart beats), and collapse of the lung (pneumothorax). Late complications of these catheters include infection of the entry site or thrombosis of the vein.

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