Description

The Swan-Ganz catheter, primarily manufactured by Edwards Lifesciences, is a specialized medical device used for invasive hemodynamic monitoring in critically ill patients. This flow-directed, balloon-tipped, multi-lumen catheter is essential for right heart catheterization and pulmonary artery pressure monitoring.

Key Functions

• Cardiac Measurements: Provides direct measurement of cardiac output, intracardiac pressures, and mixed venous oxygen saturation.
• Comprehensive Assessment: Known as the gold standard for comprehensive hemodynamic assessment, aiding in the management of complex cardiac conditions.

Clinical Applications

The Swan-Ganz catheter is invaluable in diagnosing and managing conditions such as:

• Shock (cardiogenic, distributive, septic)
• Pulmonary hypertension
• Heart failure
• Valvular heart disease
• Cardiac tamponade

It is also used for monitoring after cardiac surgeries, heart transplantation, and in patients with ventricular assist devices.

Design Features

• Multi-Lumen Design: Typically includes quadruple lumens with color-coded ports for various functions such as pressure monitoring and fluid infusion.
• Balloon Tip: Facilitates flow-directed placement and accurate pressure measurement.
• Thermistor: Near the tip for cardiac output measurement via thermodilution.
• Depth Markings: Ensures accurate positioning.

Optional Features

Advanced models may include:

• Fiberoptic sensors for continuous monitoring
• Pacing capabilities
• Additional lumens

Technical Specifications

• Length: 60–110 cm
• Diameter: 4F–8F
• Material: Made from polyvinyl chloride (PVC), with some models containing natural rubber latex.
• Sterility: Supplied sterile, single-use, and nonpyrogenic.

Insertion and Use

The catheter is typically inserted through central veins using the percutaneous Seldinger technique under sterile conditions. Continuous pressure and waveform monitoring are crucial during its use. It is generally indwelling for up to 72 hours to minimize complications.

Safety Features

• Atraumatic Tip: Minimizes vascular and cardiac trauma.
• Color-Coded Lumens: Prevents operational errors.
• Volume-Limited Syringe: Ensures safe balloon inflation.

Risks and Precautions

Potential complications include infection, arrhythmias, and pulmonary artery rupture. It is contraindicated in patients with certain conditions such as left bundle branch block and should not be used in MRI environments due to MR safety concerns.

Regulatory Information

The device is CE marked and should be disposed of as biohazardous waste after single use. Proper storage conditions and adherence to the use-by date are essential for maintaining its integrity.