Pulmonary artery catheterization via the external jugular vein.

The use of pulmonary artery catheters in assessing and managing critically ill patients has become a common practice. The risks associated with insertion of the Swan-Ganz catheter via the internal jugular or subclavian vein include pneumothorax, puncture of the carotid or subclavian artery, mediastinal infiltration, and neurologic damage. I evaluated the success and complication rates associated with placement of a pulmonary artery catheter via the external jugular vein in 25 unselected consecutive patients. Catheterization was successful in 23 of 25 patients on the first attempt. In one patient there was no visible external jugular vein, and in the other the J-wire could not be passed centrally. No complications resulted. It is concluded that pulmonary artery catheterization via the external jugular vein is safe and reliable.