A Rare Central Venous Catheter Malposition in a 10-Year-Old Girl

Movafegh, Ali; Saliminia, Alireza; Atef-Yekta, Reza; Azimaraghi, Omid

doi:10.1155/2018/2658640

Cited by 3 publications

(5 citation statements)

References 10 publications

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“…As the pushing force increases, kinking of the sheath also increases. Previous reports have shown that the tip of the catheter can travel back to the head during IJV catheterization 13,14 ; however, this does not occur with largebore catheters. 12 We postulate that a 7-Fr catheter would bend into a U shape because it is stiff and that a 9-Fr catheter would kink into a V shape because it is soft.…”

Section: Discussionmentioning

confidence: 96%

Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

et al. 2018

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Central venous catheters are used for various purposes in the operating room. Generally, the use of ultrasound to insert a central venous catheter is rapid and minimally complicated. An advanced venous access (AVA) catheter is used to gain access to the pulmonary artery and facilitate fluid resuscitation through the internal jugular vein. The present report describes a case in which ultrasound was used in a 43-year-old man to avoid complications during insertion of an AVA catheter with a relatively large diameter. The sheath of the catheter was so thin that a dilator was essential to prevent it from folding upon insertion. Despite the use of ultrasound guidance, the AVA catheter sheath became folded within the patient’s internal jugular vein. Mechanical complications of central venous catheter insertion are well known, but folding of a large-bore catheter in the internal jugular vein has rarely been reported.

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Section: Discussionmentioning

confidence: 96%

Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

et al. 2018

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“…The most possible explanation for the malfunction of these central venous lines is related with the fact that the negative intraluminal pressure due to suction is responsible for collapse of the walls of the offending vessel, which, in comparison with the superior vena cava, has a smaller internal diameter and a weaker vessel wall. Nevertheless, the existence of appropriate suction is not equivalent with correct catheter placement 24 . On the other hand, every case that is characterized by resistance or difficulty in the advancement of the catheter tip should be fashioned as a case of inappropriate direction of the catheter tip.…”

Section: Discussionmentioning

confidence: 99%

“…The use of ultrasound techniques is valuable, mainly when we aim to recognize anatomical structures before and during vessel catheterization, as it may reveal thrombosis, stenosis, anatomical variations, findings that merit special consideration in the process of catheterization. Nevertheless, several studies have failed to verify its capacity to prevent all cases of suboptimal catheter tip 24,28 .…”

Section: Prevention Of Suboptimal Placementmentioning

confidence: 99%

Malpositioning of Long-Staying Central Venous Catheters in the Pediatric Population: Incidence and Potential Complications. A Single-Center Retrospective Study and a Narrative Review of the Literature.

Kouna

Noutsos

Koufopoulou

et al. 2023

MRAJ

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Central Venous Catheters insertion is a very common procedure performed at the operation room and the Intensive Care Unit. In the paediatric population they are frequently used to administer fluids, blood products, resuscitation drugs, parenteral nutrition and chemotherapy. One of the reported complications, though a less commonly described one, is the inappropriate position of the tip of the CVC in a vessel other than the superior vena cava. In this study, we initially present the anatomy of the superior vena cava system and that of the internal jugular vein, the optimal catheter tip position as well as the possible suboptimal catheter tip locations. Subsequently, paediatric chest X-rays of our hospital with catheter tip malpositioning are illustrated, after internal jugular vein catheterization. Following, we discuss possible mechanisms of central venous catheters malpositioning, signs and symptoms which could help us identify a wrong placement and also how to prevent as well as how to fix one. Finally, an interrelation between malpositioning, malfunction and the existence of infection or thrombosis is investigated. Our study concluded that the right internal jugular vein should be the first choice in all cases of vessel implantation, mainly based on our statistical analysis results, which suggested that this vessel was associated with the least possibility of erroneous catheter placement. Another important clue of our study is based on the fact that the inappropriate positioning of a central venous catheter over the long term could be a significant predisposing factor of malfunction, along with infection and thrombosis.

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“…Resistance during central venous catheter insertion, poor blood aspiration after insertion, excessively high CVP, and abnormal waveform may be indicative of catheter malpositioning 1 , 8 but CVP monitoring was not done which may have missed early detection of malposition.…”

Section: Discussionmentioning

confidence: 99%

“…Central venous catheter (CVC) is inserted in 8% 1 of patients admitted to the hospital; it is technically challenging with known risk and complication. Complication like malposition, arrhythmia, infection, artery perforation, pneumothorax, hemothorax thrombosis has decreased by use of ultrasound during insertion of CVC.…”

Section: Introductionmentioning

confidence: 99%

Malposition of Central Venous Catheter Inserted under Ultrasound Guidance in Intensive Care Unit: A Case Series

et al. 2020

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Malposition of central venous catheter tip inserted into the subclavian and internal jugular vein is a rare unavoidable complication that can be decreased if inserted under ultrasound guidance. We report case series of three patients, two of subclavian and another of internal jugular inserted central venous catheter, in which the catheter malpositioned into ipsilateral internal jugular and subclavian vein respectively but had no effect on patient management. From this, we want to emphasize that the effect of malposition of central venous catheter tip depends upon the indication for which central venous catheter was inserted; it can be detected bedside by ultrasound and flush test.

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A Rare Central Venous Catheter Malposition in a 10-Year-Old Girl

Cited by 3 publications

References 10 publications

Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

Malpositioning of Long-Staying Central Venous Catheters in the Pediatric Population: Incidence and Potential Complications. A Single-Center Retrospective Study and a Narrative Review of the Literature.

Malposition of Central Venous Catheter Inserted under Ultrasound Guidance in Intensive Care Unit: A Case Series

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