J.Jpn. Surg. Soc.. 78(2): 148-161, 1977
Original article
FLOW DIRECTED CATHETHER (SWAN-GANZ CATHETER) IN CARE OF SURGICAL PATIENT : STUDIES ON HEMODYNAMICS IN SURGICAL DISEASE, FIRST REPORT
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First Department of Surgery, Fukusima Medical College Ryoichi Motoki, et al. |
In our clinic one hundred fourty six cases (heart disease 59, esophageal cancer 24, severe infection 18, esophageal varices 11, massive bleeding 9 and others 25) were analysed with the Swan-Ganz catheter.
The results are as follows :
1) The preoperative hemodynamics of the 10 cases who had good preoperative codition and recieve minimal operative trauma was within normal range. (CI = 3.4±0.3 L/min/M2, PAP = 18.4±1.4 mmHg, PWP = 9.0±1.0 mmHg, and RAP = 5.9±1.6 mmHg). In these cases the slight hypovolmic changes were observed at the early postoperative period with decreased Cl, PAP, PWP and RAP. The changes had recovered almost completely at 48 hrs after the operation.
2) The catheter was inserted at the immediatly after the operation in cases of heart disease. In esophageal carcinoma cases it was done a day before the operation.
3) The average indwelling period was 3.8 days and in 72% of all cases the catheter was tooked off within 4 days.
4) Catheter were easily entered in all 146 cases except one who had recieved thoracoplasty and had developed lung cancer.
5) In 4 cases of all, the cable from the thermister to pin piugs lost the continuty during the indwelling.
6) In 17 cases, the pulmonary wedge presure could not be measured during the indwelling. In 15, shift of the catheter tip might be cause of it. The balloon rupture was observed remaining 2 cases.
7) Cardiac arrhythmias were less frequent than with other type of catheter in the insertion. No severe arrhythmias were observed during the indwelling.
8) In 3 patients triangle shaped shadows were seen on their chest X-ray without episode of hemoptysis. The changes were disapeared within 3 days. The temporal partial occlusion of the pulmonary artery might be considered as a course of the shadow.
9) There was no other complication related the catheter.
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