Pulmonary hemorrhage associated with balloon flotation catheters: report of a case and review of the literature

The development of the flow-directed balloon catheter has greatly facilitated the monitoring of seriously ill patients. As the use of this catheter has increased, so have the reports of complications, the most serious of which is fatal pulmonary hemorrhage. Eleven cases of pulmonary hemorrhage have been described in the literature, and we have reported an additional case. The presenting symptom in 10 patients was hemoptysis, and the course of eight of these patients was rapidly fatal. The most frequent significant finding at autopsy was a laceration of a small peripheral pulmonary artery, usually at a bifurcation. The pathogenesis, prophylaxis, and management of this complication are discussed.