Cardiac perforation associated with continuous infusional chemotherapy

Depth of Central Venous Catheter Insertion in Adults: An Audit and Assessment of a Technique to Improve Tip Position

“…Hickman catheters) have been reported over the last twelve years. The reports describe perforation of the SVC, RA and the right ventricle by CVCs including silastic [11][12][13][14][15][16][17][18][19] and polyurethane [20][21][22][23][24][25] catheters inserted for short periods (minutes to hours) and over the longer term in neonates 11,[15][16][17][18][19]20,[27][28][29][30][31] , children 12,14,24,32,33 and adults 12,13,20,21,23,24,31,[34][35] .…”

“…Of these case reports, 44 (67%) related to CVC insertion in patients over 12 years of age 12,13,20,21,[23][24][25]31,[34][35] and thirty (68%) of these 44 cases were fatal. An additional three patients were left in a persistent vegetative state after resuscitation.…”

“…The manufacturer of the CVC and the material used were specified in only 12/44 cases 20,21,24,30,40 . In the remainder, the material type was mentioned in 10/44 cases but not the manufacturer 12,13,23,25,38,39,42,43 . Neither the manufacturer nor the material were reported in half (22/44) of the case reports 31,34,35,37,41,44,45 .…”

“…Neither the manufacturer nor the material were reported in half (22/44) of the case reports 31,34,35,37,41,44,45 . Seven catheters were polyethylene 36,38,42,43 , one PVC 39 , five silicone 12,13 , two teflon 24 and seven polyurethane 20,21,23,24,25,40 . It is necessary to include the name of the manufacturer, as not only does catheter stiffness differ between different makes of CVCs, it may also differ between those composed of the same material by the same manufacturer 46,47 .…”