FALSE PULMONARY-ARTERY CATHETER MEASUREMENTS DUE TO THE SCIMITAR (HYPOGENETIC LUNG) SYNDROME - POTENTIAL FOR LATROGENIC PULMONARY-EDEMA

In an acute trauma patient with unrecognized scimitar syndrome, physio logic measurements used in patient management decisions were misleadin g due to the anatomic and physiologic anomalies of the syndrome. Pulmo nary artery catheter measurements believed to reflect left atrial pres sures were actually measuring central venous pressures because the cat heter was terminating in the scimitar vein. These erroneous measuremen ts led to overly aggressive fluid resuscitation and iatrogenic pulmona ry edema. The pathologic features of scimitar syndrome are reviewed, a nd the mechanism for potential mismanagement of patient volume status created by aberrant pulmonary hemodynamics is discussed.