Accidental placement of central venous catheter into internal mammary vein: A rare catheter malposition

Kela, Manish; Munde, Haridas; Raut, Sushil

doi:10.4103/aca.aca_106_17

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…3 Malposition of catheter is a common complication and reported incidence varies from 2-5%. 2,4 Although, catheterisation through right internal jugular vein is preferred because of its relatively straight course but subclavian catheterisation is done more commonly because of large calibre of vein and fixed course. Ideally the tip of central catheters should be at the level of midlower superior vena cava to cavoatrial junction.…”

Section: Discussionmentioning

confidence: 99%

Mediastinal malposition of catheter after venous cut down

Nasir

Gupta

et al. 2018

Int Surg J

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Central venous catheterization is one of the very essential tool of modern intensive care. Apart from monitoring the critically ill patient, it helps in administration of antibiotics, parenteral nutrition, chemotherapy, fluids and drug delivery. Peripheral inserted central catheter (PICC) by surgically isolating basilic vein or venous cut down, is considered one of the safe technique to access central veins. The advantage of this procedure is that traumatic complications like pneumothorax, hemothorax and arterial puncture are less as compared to directly placing central catheters. Malposition (intracaval or extracaval) is one of the commonly encountered complication associated with central venous catheterization. Extracaval is rarely encountered and there are isolated case reports in the literature where catheter tip is found outside the central vein into the surrounding structures. Knowledge of such complications is important else these remain unrecognized resulting in delayed treatment and poor outcome. Here, we report a unique case, wherein tip of infant feeding tube inserted from basilic vein was found in anterior mediastinum resulting bilateral hemothorax and pleural effusion.

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Section: Discussionmentioning

confidence: 99%

Mediastinal malposition of catheter after venous cut down

Nasir

Gupta

et al. 2018

Int Surg J

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“…In one case, the position could not be ascertained in a symptomatic patient till a computed tomography (CT) was done. [1] Kela[2] also reported a persistently high CVP (18-22 cms H 2 O) in a similar scenario but it was detected during left internal mammary artery dissection in a patient who was undergoing coronary artery bypass grafting and was subsequently removed.…”

mentioning

confidence: 95%

Prediction of inadvertent internal mammary (thoracic) vein cannulation by CVP monitoring

Tara

Rai

Chauhan

2019

J Anaesthesiol Clin Pharmacol

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“…Variousmal positions of CVC can be its placement in internal mammary vein, coiling within the vein itself, migration of catheter to ipsilateral jugular vein from subclavian vein or translocation to the contralateral subclavian vein etc. [1][2][3] Pericardial effusion and pericardial tamponade are rare but accounting for up to 0.7% of central venous catheter related complications 4,5 Recommended use of post-insertion chest radiograph or using any other radiological method for the confirmation of correct placement and detection of complications like pneumothorax should be employed.…”

Section: Introductionmentioning

confidence: 99%

Very rare and serious complication of central line insertion

Sood¹

2019

IJCA

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Central venous catheter (CVC) placement is indicated for various therapeutic and diagnostic purposes. However, it is important to ensure its proper placement. A CVC malposition is associated with number of recognized complications, some of which can be fatal. Case: In a 27 year female admitted in ICU with history of seizures and oral bleed with stable vitals, 7Fch subclavian CVC was inserted. She had progressive dyspnea, chest pain and hypotension. Although chest X-ray showed correctly positioned CVC, CECT chest showed it was entering SVC, traversing along its medial wall and reaching between SVC and aorta and entering in the right atrium. Also atelectic fluid in oblique fissure, bilateral pleural effusion and small pocket of air in anterior mediastinum with minimal mediastinal high attenuation collection was seen. This was removed and patient was under observation for 24 hours, after which she was shifted to ward. Conclusion: Therefore location of the catheter must be verified by radiological methods. Also real-time ultrasound reduces the number of complications associated with the technique.

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Accidental placement of central venous catheter into internal mammary vein: A rare catheter malposition

Cited by 9 publications

References 5 publications

Mediastinal malposition of catheter after venous cut down

Mediastinal malposition of catheter after venous cut down

Prediction of inadvertent internal mammary (thoracic) vein cannulation by CVP monitoring

Very rare and serious complication of central line insertion

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