Extracorporeal membrane oxygenation for Swan-Ganz induced intraoperative hemorrhage.

We herein present the case of a 75-year-old woman undergoing double valve replacement who experienced a massive bronchial hemorrhage due to a Swan-Ganz catheter pulmonary artery perforation after weaning from cardiopulmonary bypass. Early institution of extracorporeal membrane oxygenation allowed treatment of severe hypoxemia, refractory to mechanical ventilation, and the discontinuation of hemoptysis. Once clinical stability was achieved, the patient underwent pulmonary artery angiography with successful pseudoaneurysm embolization.

Effects of sternotomy on heart-lung interaction in patients undergoing cardiac surgery receiving pressure-controlled mechanical ventilation.

Background: The key concept underlying the dynamic indexes of preload dependence is the physiological heart-lung interaction. During sternotomy this interaction undergoes various changes, some of which remain unclear. Our primary aim was to investigate how the interaction changes during sternotomy by evaluating pulse pressure variations (PPV) with the chest closed and after sternotomy in patients ventilated using the pressure-controlled mode.