Bilateral hydrothorax and cardiac tamponade after right subclavian vein catheterization -A case report-

Abstract

Central venous catheterization is typically used for the anesthetic management of patients undergoing a major surgery or care of patients in Intensive Care Unit (ICU). The occurrence of complications associated with central venous catheterization such as pneumothorax or vascular injury have decreased, while delayed complications such as hydrothorax, hydromediastinum, or cardiac tamponade have risen recently. We report a case of complications of bilateral hydrothorax with cardiac tamponade by superior vena cava perforation due to continuous mechanical force of the looped central venous catheter tip against SVC wall after subclavian vein cannulation.

Delayed Massive Hydrothorax Following Subclavian Catheter Insertion

“…7 The terminal should ideally be located parallel to the blood vessel wall in the superior vena cava. The type of fluids like hyperosmotic fluid used in total parenteral nutrition, lipid drugs may cause intimal damage of the blood vessel, and catheter may translocate out of the blood vessel through the intima that is damaged.…”

Geriatric neuroanesthesia: the retrospective study of 158 patients

“…Ancak kateterizasyon esnasında pnömotoraks gibi komplikasyonlar görülebilir (16). Bu nedenle, biz de santral venöz kateterizasyonu hemodinamik yönden instabil olan anevrizma, arteriovenöz malformasyon ve intrakranial kitle operasyonu geçirecek hastalara uyguladık.…”

Optimal head rotation and puncture site for internal jugular vein cannulation after laryngeal mask airway insertion

“…(12) Takeyama et al recommended the use of a lower puncture point -near the area where the clavicular head of the sternocleidomastoid muscle (SCM) attaches to the clavicle; the CCA was not observed to be in the vicinity of the IJV when the patient was in that position even after LMA insertion. (10) Although the authors performed test punctures at the supraclavicular lower puncture point in 20 patients without any complications, Kim et al (13) opined that the supraclavicular puncture could still be associated with pneumothorax, hydrothorax or cardiac tamponade. Takeyama et al evaluated the puncture point using only a 30° head rotation, (10) without evaluating the effect of different degrees of head rotation.…”

“…(10) Although the authors performed test punctures at the supraclavicular lower puncture point in 20 patients without any complications, Kim et al (13) opined that the supraclavicular puncture could still be associated with pneumothorax, hydrothorax or cardiac tamponade. Takeyama et al evaluated the puncture point using only a 30° head rotation, (10) without evaluating the effect of different degrees of head rotation.…”

“…Lieberman et al reported that an increase in head rotation was associated with a higher probability of CCA contact; (11) we postulated that the effect of head rotation would be similar in patients with LMA insertion. If the degree of overlap between the right IJV and the right CCA varies according to the degree of head rotation after LMA insertion, the degree of head rotation with the least amount of overlap can be determined and the risk of CCA puncture can therefore be reduced.The central landmark approach, which is commonly used for IJV cannulation, was shown to have a low success rate in patients with LMA insertion.(12) Takeyama et al recommended the use of a lower puncture point -near the area where the clavicular head of the sternocleidomastoid muscle (SCM) attaches to the clavicle; the CCA was not observed to be in the vicinity of the IJV when the patient was in that position even after LMA insertion.(10) Although the authors performed test punctures at the supraclavicular lower puncture point in 20 patients without any complications, Kim et al (13) opined that the supraclavicular puncture could still be associated with pneumothorax, hydrothorax or cardiac tamponade. Takeyama et al evaluated the puncture point using only a 30° head rotation, (10) without evaluating the effect of different degrees of head rotation.…”