If the tip of a pulmonary artery catheter is positioned incorrectly over the right mid lung, what should be done?

The appropriate action when the tip of a pulmonary artery catheter is incorrectly positioned over the right mid lung is to inflate the balloon and advance the catheter. This technique is commonly employed to facilitate the proper placement of the catheter into the pulmonary artery. When the balloon is inflated, it creates a flotation effect, allowing the catheter to move along the flow of blood in the right heart chambers and into the pulmonary artery.

Advancing the catheter after balloon inflation helps ensure that it navigates past any obstructions or anatomical variations that might be causing it to rest in the wrong position. This method is safely used in clinical practice to achieve the optimal placement of the catheter for accurate hemodynamic monitoring and therapy.

In contrast, simply withdrawing the catheter may result in failing to address the incorrect positioning, while rotating away from the hilum or puncturing the pericardial wall may lead to complications. Therefore, advancing the catheter while the balloon is inflated is a standard and effective approach for repositioning the pulmonary artery catheter correctly.