Pulmonary artery catheter-induced hemorrhage.

Pulmonary artery rupture by a flow-directed balloon-tipped catheter is a rare complication if guidelines for insertion of catheters are strictly applied. It should be stressed that the need for a "confirmed" wedge pressure should be weighed against the very real risk of this potentially fatal complication. Users of this catheter should expect and anticipate distal migration of the catheter tip. Great care must be exercised in inflating the balloon, particularly when the location of the catheter tip in the pulmonary vascular bed is unknown. Excessive catheter manipulation should be avoided. Hemoptysis, hemothorax, cardiac or respiratory instability in patients who have the PA catheter should be suspected to have this grave complication and appropriate emergency measures should be taken until this complication has been ruled out.