Shevde K, Raab R, Lee P
Department of Anesthesia, Maimonides Medical Center, Brooklyn, NY 11219.
J Cardiothorac Vasc Anesth. 1994 Feb;8(1):30-4. doi: 10.1016/1053-0770(94)90008-6.
A pressure relief balloon has been recommended as one way to decrease catheter-related pulmonary artery rupture (PAR). There are approximately 1 to 2 PARs per 1,000 pulmonary artery catheter (PAC) insertions, resulting in significant morbidity and mortality. A new pressure relief balloon (PRB) introduced by Biosensors International (Singapore) was studied for its efficacy in increasing safety during PAC flotation balloon (FB) inflations. Ten human placentae were used for the experiment. The Biosensors PACs and the commonly used Baxter-Edwards (Irvine, CA) catheters were placed in placental veins and their FBs were gradually inflated with a maximum of 1.5 mL of air. Data revealed that PRBs consistently inflated when resistance was met by FBs and inflation pressure reached 1,000 mmHg. When PRBs were removed, the FBs inflated asymmetrically and distended beyond the catheter lumen or protruded through the vessel wall, causing bleeding upon deflation. Without the PRB, pressures reached up to 1,700 mmHg. In addition, the PRB gave visual evidence of resistance to the FB. In conclusion, the PRB is a safety device that limits overinflation of the distal PAC balloon, thus preventing vessel rupture. The device deserves serious consideration and outcome analysis.
减压球囊被推荐为降低导管相关肺动脉破裂（PAR）的一种方法。每1000次肺动脉导管（PAC）插入中约有1至2例PAR，会导致显著的发病率和死亡率。对百胜国际（新加坡）推出的一种新型减压球囊（PRB）在PAC漂浮球囊（FB）充气过程中提高安全性的效果进行了研究。实验使用了10个人类胎盘。将百胜PAC和常用的百特-爱德华兹（加利福尼亚州欧文市）导管置于胎盘静脉中，其FB逐渐充气，最多充入1.5毫升空气。数据显示，当FB遇到阻力且充气压力达到1000 mmHg时，PRB会持续充气。当移除PRB后，FB会不对称充气并扩张至超出导管腔或穿透血管壁，放气时会导致出血。没有PRB时，压力可达1700 mmHg。此外，PRB能直观显示对FB的阻力。总之，PRB是一种安全装置，可限制远端PAC球囊过度充气，从而防止血管破裂。该装置值得认真考虑和进行结果分析。
