Invasive monitoring in anesthesiology is relatively safe. Arterial catheterization in particular has an extremely low rate of serious complications. Radial, brachial, and femoral artery catheterization sites appear to have similar and low complication rates. CVP and PA catheters are more dangerous and entail potentially fatal complications. The most troublesome complication with CVP catheters i...

A 50-year-old woman with a history of deep venous thrombosis presented to our clinic for evaluation of pulmonary hypertension. On examination, she had a strong pulmonary component of the second heart sound and a grade 2/6 systolic murmur on the left sternal border. Echocardiography revealed severe right ventricular dilatation, with mildly depressed function and severe tricuspid regurgitation. E...

A 49-year-old woman with primary pulmonary hypertension diagnosed 1 year previously was admitted as part of a research study at Harefield Hospital. She had no known precipitating factors or family history of the disease. Her main symptoms included exertional dyspnea and syncope. Her pulmonary artery systolic pressure was 110 mm Hg, with a mean pulmonary artery pressure of 85 mm Hg. A 24-hour am...

gy allows critical care practitioners to continuously monitor and evaluate tissue oxygenation at the bedside by using a fiberoptic pulmonary artery catheter that measures mixed venous oxygen saturation (S–vO2). Placement of a pulmonary artery catheter to measure S–vO2 may not always be feasible early in resuscitation or outside the intensive care unit (ICU). A new technology that uses a modifie...