[Complications of the use of the pulmonary flotation catheter in surgery. Prospective study]

We studied 120 insertions of the Swan-Ganz catheter in 119 patients who needed hemodynamic monitorization for cardiovascular surgery. All catheter insertions were carried out soon after the anesthetic induction employing the modified Seldinger technique through the internal jugular vein, taking as reference the intracavitary pressure waves to get the pulmonary artery wedge position. The time of insertion, time of use, complications of puncture, difficulty and complications of insertion, thoracic and pulmonary complications, and loop or knot in the catheter were examined.

multiple punctures in 15 cases (12.5%), 8 carotid artery punctures (6.6%), 14 hematomas (11.6%), difficulty for pass through the right ventricle in 8 cases (6.6%) and pulmonary artery in 32 (26.6%) impossibility to get the pulmonary wedge position in 13 cases (10.8%), loop of catheter in 3 (2.5%), ectopic atrial beats in 30 cases (25%), atrial tachycardia in 4 (3.3%), ectopic ventricular beats in 73 (60.8%). General arrhythmia incidence was 67.5%, none serious. All complications were minor and not life-threatening. Only in two cases (1.6%) the complications were major, both pulmonary infarction, but were life-threatening to patients; in 20 patients (16.6%) the outcome was without complications. There were no deaths for the catheter use. The results of this study showed that complications caused by the pulmonary artery flotation catheter were smaller than the benefit obtained in the management of these patients.