Complications of pulmonary artery catheterization: A prospective study in open heart surgery patients

Pulmonary artery was catheterized in 125 adult patients undergoing various open-heart surgical procedures for perioperative haemodynamic monitoring. A standard approach to right internal jugular vein was used in all patients. Complications noted were related either to central venous access, pulmonary artery catheter (PAC) threading and during stay of catheter in the pulmonary artery. Post-operatively, X-ray chest was done in every patient and tip of the catheter was sent for culture once the PAC was removed. There was 8.8% incidence of inadvertent carotid artery puncture. Pneumothorax occurred in one patient. Arrhythmias occurred in 49.6% of the patients. New right bundle branch block occurred in 10.4% of the patients, while none of the 11 patients with a pre-existing left bundle branch block developed complete heart block during pulmonary artery catheterization. There was no incidence of pulmonary artery rupture associated with the use of PAC. There was a 9.6% incidence of PAC colonization which was seen on culture of catheter tip. This investigation revealed a low incidence of morbidity associated with the use of PAC.