Why is anticoagulation a concern when placing a Swan-Ganz catheter?

When placing a Swan-Ganz catheter, anticoagulation is a concern primarily because it can lead to complications such as rupture. The placement of this catheter involves threading a flexible catheter through the large veins, typically accessing the right atrium and navigating to the pulmonary artery. This procedure carries risks, especially in patients who are on anticoagulants, as the likelihood of bleeding increases.

If a blood vessel is inadvertently punctured or if there is trauma to the vessel wall during placement while the patient is anticoagulated, it could result in a rupture. This bleeding could be severe and lead to life-threatening consequences. Furthermore, anticoagulation can make it challenging to control bleeding, thereby exacerbating the situation.

The other listed concerns, such as embolism, oxygenation, and airway resistance, are indeed important considerations in various clinical scenarios, but they are not the primary reason anticoagulation poses a significant risk during Swan-Ganz catheter placement. The focus is squarely on the risk of vascular injury and the potential for hemorrhage, which is heightened in the context of anticoagulation therapy.