Malposition of Central Venous Catheter – Three case reports

Abstract

Central Venous Cannulation is a routine procedure done in the Operation Theatre and the Intensive Care Unit. Malpositioning is a very common occurance with the regular anatomical landmark technique. As the central venous catheters are essential in various critical care scenarios, hence any misplacement can hamper its purpose. Here we have three cases where in we saw the migration of the Right Subclavian Vein Catheter into the Ipsilateral Internal Jugular Vein, Contralateral Subclavian Vein and into the Ipsilateral External Jugular Vein radiologically. Hence a thorough knowledge of normal and variant anatomy is required for the proper positioning of Central Venous Catheters. Also radiological techniques like ultrasound guided cannulation may avoid inadverdent arterial puncture but may not be able to avoid malpositioning.

A catheter malpositioned patient with pain and paresthesia

“…Central venous catheterization is associated with several potential complications including pneumothorax, A catheter malpositioned patient with pain and paresthesia thrombosis, bleeding, arrhythmias, infection and malposition (3)(4)(5)(6)(7)(8). Malposition of central venous catheter is not uncommon and can lead to disastrous consequences like perforation, thrombosis, local toxicity, neurologic deficit and hematoma (9,10).…”