Haapaniemi J, Gadowski R, Naini M, Green H, MacKenzie D, Rubenfire M
Cathet Cardiovasc Diagn. 1979;5(2):151-7. doi: 10.1002/ccd.1810050209.
Hemoptysis is an unusual complication of flow-directed (Swan-Ganz) catheters. Over-inflation of the balloon with a shearing-induced rupture of a small pulmonary artery, and the spear effect of the catheter tip appear to be the mechanisms in the two cases presented. Diligent care to avoid overinflation of the balloon in the pulmonary capillary wedge position by observation of the pressure waveform is critical. The spear effect that is frequently seen during insertion may be eliminated by deflating the balloon at the first appearance of the pulmonary artery waveform and gradual advancement of the catheter five to eight cm, when the balloon is then reinflated to obtain the wedge.
咯血是血流导向型（Swan-Ganz）导管的一种罕见并发症。本文所呈现的两例病例中，球囊过度充气导致小肺动脉剪切性破裂，以及导管尖端的 spear 效应似乎是其发病机制。通过观察压力波形，精心护理以避免在肺毛细血管楔压位置时球囊过度充气至关重要。在插入过程中经常出现的 spear 效应，可在肺动脉波形首次出现时使球囊放气，并将导管逐渐推进 5 至 8 厘米，然后再次充气球囊以获取楔压，从而消除该效应。
