To the Editor.–Since Swan and Ganz advocated the use of the balloon flotation catheter for measurement of pulmonary artery pressure in monitoring critically ill patients, the importance of this method has been well demonstrated by many investigators. It has also been noted that pulmonary wedge pressure has occasionally been unobtainable, despite seemingly adequate positioning of the catheter tip, without reasonable explanation other than balloon rupture. In the following case we observed a complication previously unknown to us.
A 73-year-old man underwent total gastrectomy, splenectomy, and esophagojejunostomy for carcinoma of the stomach. Postoperatively, he developed pancreatitis, sepsis, and acute renal failure. He was transferred to the Shock and Trauma Unit for exten
Balloon was visualized by injecting 1.5 ml of a mixture of diatrizoate sodium and diatrizoate meglumine (Renografin 40). Note 180-degree turn of catheter tip (arrow). sive monitoring. A No. 7 French Swan-Ganz catheter was inserted through the subclavian