PACs -- why can't you infuse through the distal lumen?

Specialties CCU

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Hello, very confused nursing student here, if somebody could please help clarify that would be great :)

I understand that with a Swan Ganz you're only supposed to infuse through the VIP/CVP proximal ports which exit into the RA, and that you're NOT supposed to infuse through the PAP/distal lumen (unless it's a code emergency). I've been doing quite a bit of research but haven't been able to find an explanation as to why. Does it have something to do with the RA being a better option because it's a bigger chamber with lower pressure versus the PA which has higher pressure and is smaller/narrower in size?

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Specializes in Trauma | Surgical ICU.

The reason why we do not infuse anything from PA | distal port is because we have to see the waveform. This is our only indication where the catheter is (as each chamber of the heart looks different). If we infuse anything on it, we loose the ability to know if the catheter is too far and may cause dysrhythmias.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

You might find this useful.....https://allnurses.com/micu-sicu-nursing/pa-catheters-swan-897738.html

The distal tip of the catheter is in the pulmonary artery close to the capillary beds. So you would be infusing into the lungs....

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The chance of air/particle embolism is high so it is NOT used. When used in a code situation it the other ports are not functional the catheter is withdrawn to an infusable position.

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The above explanations are indeed true, I just want to add that infusion rates and certain medications run the risk of literally causing trauma to the fragile beds. This rationale is also why wedging PA's is becoming outdated...the risk of blowing out the PA/capp beds is too high to continue to justify in a lot of cases.

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