Sumita S, Ujike Y, Namiki A, Watanabe H, Watanabe A, Satoh O
Department of Anesthesiology, Sapporo Medical University and Hospital, Japan.
Intensive Care Med. 1995 Jan;21(1):79-81. doi: 10.1007/BF02425160.
A case of pulmonary artery rupture induced by balloon occlusion pulmonary angiography (BOPA) is reported. A flow-directed pulmonary artery catheter had been inserted for hemodynamic monitoring in a septic shock patient complicated by acute respiratory distress syndrome. To check for pulmonary damage, BOPA was performed immediately after hemodynamic measurement. Just as the hand injection of contrast medium was ending, the patient began to cough and a small amount of hemoptysis was observed. The angiogram showed the extravasation of contrast medium from the distal pulmonary artery to the situation of catheter tip. Pulmonary hemorrhage was controlled with mechanical ventilatory support with 10 cmH2O positive end-expiratory pressure and no specific therapy was required. This complication should be kept in mind and using a power injector to avoid injurious transient high pressure pulse is recommended.
报道了1例球囊阻塞肺动脉造影术（BOPA）诱发的肺动脉破裂病例。一名合并急性呼吸窘迫综合征的感染性休克患者插入了血流导向肺动脉导管以进行血流动力学监测。为检查肺部损伤情况，在血流动力学测量后立即进行了BOPA。就在手动注射造影剂即将结束时，患者开始咳嗽，并观察到少量咯血。血管造影显示造影剂从肺动脉远端外渗至导管尖端所在位置。通过给予呼气末正压10 cmH2O的机械通气支持控制了肺出血，无需特殊治疗。应牢记这一并发症，建议使用动力注射器以避免有害的短暂高压脉冲。
