Thread by @ICUAdvantage

The Swan-Ganz Catheter 🦢🫀

AKA, the Pulmonary Artery Catheter or PA Catheter.

A thread discussing the basics of our PA Cath:
#MedTwitter #FOAMed #ICU

The PA Cath is a specialized venous catheter that can give us a whole host of values related to cardiac function, hemodynamics, and perfusion. 🧐

This cath is a long balloon tipped cath that enters the venous system. It is passed into the RA, through the tricuspid valve, into the RV, and then finally through the pulmonic valve with the tip resting in the pulmonary artery (PA). 🫀

The location and position of the catheter along this path allows us an opportunity to sample or measure pressure at various points. This gives us many measurements and information related to the patients' hemodynamics. 👍🏼

Our most basic PA catheter has 4 lumens:

⚪️ Proximal Infusion Port (White) - this is the most proximal port from the tip and is used to infuse fluids or meds. It typically terminates in the RA or vena cava.

🔵 Right Atrial Port (Blue) - this I just slightly distal to the white port and is transduced to get our patient's RAP/CVP. It is also the port that fluid is injected for intermittent cardiac output measurements.

🟡 PA Distal Lumen (Yellow) - this is the most distal, at the top of the catheter in the pulmonary artery. It is transduced to get the pulmonary artery pressure (PAP) as well as wedge pressure (PCWP/PAOP). This is also the port sampled for a mixed venous blood gas.

🔴 Balloon Port (Red) - this has a connected special 1.5ml syringe used to inflate the balloon near the tip of the catheter. This is used to help float the catheter along during insertion and to obtain a wedge pressure.

Beyond these basic functions, some PA catheters have the capability to get intermittent or continuous cardiac output measurements, continuous SvO2, as well as transvenous pacing capabilities. 😮⚡️

To learn more about the PA cath including why we use them and when we don't, then watch the latest lesson on YouTube where I discuss just that! 👀🎥