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spontaneous pulmonary hemorrhage during diagnostic cardiac catheterization

Date: Oct 27, 2023

Question:

"After angiography hemorrhage was noted from the ETT. This was treated with frequent suctioning, PEEP, exchanging the ETT, reversal of heparin, nitric oxide, temporary RPA balloon occlusion (7mm diameter x 2cm long Tyshak 2 balloon with RLL wire position, this was the lung field where infiltrates were noted), and transitioning to a Servo ventilator. The decision to end the procedure was made. Serial ABGs and ACTs were repeated as the bleeding was controlled. Patient oxygenation was never poor but ventilation was and it slowly improved as the bleeding was controlled. We estimated EBL out the ETT of about 50ml. All catheters and right-sided sheaths were removed and hemostasis was obtained with direct pressure prior to the application of a Safeguard. The LFV sheath was exchanged for a 5 Fr x 8cm CVL, which was sterilely dressed." 

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