Accidental placement of central venous catheter in lung parenchyma causing hydrothorax

Badada, Vivek; Singh, Tapas Kumar; Srivastava, Uma

doi:10.4103/1658-354x.144090

Cited by 6 publications

(8 citation statements)

References 6 publications

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“…Catheter‐related complications continue to be a major challenge to the safe delivery of PN. Complications include placement‐related events (pneumothorax, arterial cannulation, and line malposition), infection, thrombosis, and thrombophlebitis, as well as rare complications such as pericardial tamponade, cardiac perforation, and even death 105 . ‐ 109 Estimates of the incidence of complications vary from 1.5–4.9 per 1000 catheter days, depending on the patient population, severity of illness, and the type of catheter 97 , 109 , 110 …”

Section: Pn Complicationsmentioning

confidence: 99%

Management of Parenteral Nutrition in Hospitalized Adult Patients

Mundi

Nystrom

Hurley

et al. 2016

J Parenter Enteral Nutr

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Despite the high prevalence of malnutrition in adult hospitalized patients, surveys continue to report that many clinicians are undertrained in clinical nutrition, making targeted nutrition education for clinicians essential for best patient care. Clinical practice models also continue to evolve, with more disciplines prescribing parenteral nutrition (PN) or managing the cases of patients who are receiving it, further adding to the need for proficiency in general PN skills. This tutorial focuses on the daily management of adult hospitalized patients already receiving PN and reviews the following topics: (1) PN basics, including the determination of energy and volume requirements; (2) PN macronutrient content (protein, dextrose, and intravenous fat emulsion); (3) PN micronutrient content (electrolytes, minerals, vitamins, and trace elements); (4) alteration of PN for special situations, such as obesity, hyperglycemia, hypertriglyceridemia, refeeding, and hepatic/renal disease; (5) daily monitoring and adjustment of PN formula; and (6) PN-related complications (PN-associated liver disease and catheter-related complications).

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Section: Pn Complicationsmentioning

confidence: 99%

Management of Parenteral Nutrition in Hospitalized Adult Patients

Mundi

Nystrom

Hurley

et al. 2016

J Parenter Enteral Nutr

View full text Add to dashboard Cite

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“…Sonography is useful for the assessment of catheterization complications such as pneumothorax and hemothorax (2). In our case, misplacement of the catheter tip into the pleural space was misjudged on plain radiography.…”

Section: Hydrothorax Is a Rare Condition (2) Jabeen Et Al (3)mentioning

confidence: 89%

“…Bedside sonography is the most effective method for ensuring that the catheter tip is located at the junction of the right atrium and vena cava superior (3). Agitated saline bubble-enhanced transthoracic echocardiography is a highly reliable method for assessing the location of the catheter tip (2). Hydrothorax may result from the infusion of fluid into a CVC misplaced in the pleural space.…”

Section: Hydrothorax Is a Rare Condition (2) Jabeen Et Al (3)mentioning

confidence: 99%

“…Moreover, CVCs are the most commonly used catheters to establish peripheral venous access in patients hospitalized for prolonged periods (1). Hydrothorax is a rare complication related to central venous catheterization (2). Jabeen et al (3) reported that subclavian intervention can result in rupture of the vessel wall and subsequent misplacement of the catheter tip in the pleural space.…”

Section: Introductionmentioning

confidence: 99%

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Hydrothorax caused by catheter malposition misdiagnosed via using plain radiography

Ergül¹,

Özcan²,

Torun³

2017

J Turgut Ozal Med Cent

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We report the case of a child with hydrothorax caused by the misidentification of catheter malposition using plain radiography. A 9-month-old girl underwent central venous catheterization via the right subclavian vein. Catheter tip was evaluated mistakenly as in the right atrium by plain radiography. The catheter was retracted 2 cm and 1/3 normal saline infusion was initiated at 15 ml/hr. The patient became hypoxemic at the 20th hour of fluid infusion. On radiography, the right lung was completely opaque and the catheter tip was positioned in the right lung. Bedside sonography revealed a massive pleural effusion in the right lung and the catheter tip in the right pleural space. The catheter was removed and the pleural effusion was drained via chest tube. The location of the catheter tip should be determined by an accurate technique before infusing fluid. Plain radiography can be misleading for the detection of malposition.

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“…Yapılan ekokardiyografik incelemede kateter ucunun plevral boşlukta olduğu görülmüştür. Literatürde kateter girişimine bağlı hidrotoraks görülen vakalar mevcuttur (13). Bir diğer hastamızda ise kateter ucunun direkt grafide ventrikülde olduğu görülmüş, ekokardiyografi yapılmış ve kateterin foramen ovale aracılığı ile sol ventriküle geçtiği anlaşılmıştır.…”

Section: Discussionunclassified

Evaluation of Central Venous Catheterization Complications and Related Risk Factors in a Pediatric Intensive Care Unit

Ergül¹,

Özcan²,

Aslaner³

et al. 2016

Yoğun Bakim Derg

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Objective: In this study, we aimed to evaluate central venous catheter insertion related complications and related risk factors in a pediatric intensive care unit. Material and Methods:All patients hospitalized between 17.10.2012 and 24.08.2014 in a pediatric intensive care unit were included in the study. Central venous catheterization patients in terms of age, sex, cause of catheter insertion, and removal, depending on catheter interventions, were evaluated in terms of developing complications and risk factors.Results: A total of 139 catheter insertions were performed. The success rate of catheterization was 95%, attempt complication rate was 21.6%, and catheter-related blood stream infections occurred for 16.2 catheter days per 1000 catheterization days. The median duration of the catheters in place was 14 days (1-68) days. The most common site of intervention was the femoral region (38.8%), followed by subclavian (30.9%) and jugular regions. The most common complication of attemps was arterial puncture (12.2%), followed by malposition (4.3%), pneumothorax (3.5%) and other complications (2.1%). Serious complications were most common in subclavian insertions (p<0.05). After insertion, the most common complication during follow-up was catheter-associated bloodstream infection. There were no significant differences between the regions in terms of catheter-associated bloodstream infections (p>0.05). The risk of infection increased with increased duration of hospitalization (p>0.05).Conclusion: Despite associated complications, central venous catheter placement is a safe procedure in children. We suggest preference of the femoral or internal jugular vein initially, instead of the subclavian vein, because of fewer serious insertion-related complications. (Yoğun Bakım Derg 2016; 7: 9-14) Keywords: Children, complication, central venous catheterization, critical care Bulgular: Toplam 139 kateter girişimi yapıldı. Kateterizasyon başarı oranı %95, girişim komplikasyonu oranı %21,6, kateter ilişkili kan akımı enfeksiyonu oranı her 1000 kateter gününe 16,2 idi. Kateter kalış günü ortanca 14 (1-68) gün idi. En sık tercih edilen girişim bölgesi femoral bölge (%38,8) idi, bunu takip eden subklavyen (% 30,9) ve juguler (%30,2) bölgeydi. En sık görülen girişim komplikasyonu arterial ponksiyon (%12,2) idi, bunu sırasıyla malpozisyon (%4,3), pnömotoraks (%3,5) ve diğer komplikasyonlar (%2,1) izlemekte idi. Ciddi komplikasyonlar daha çok subklavyen bölge girişimlerinde görüldü (p<0,05). En sık görülen izlem komplikasyonu kateter ilişkili kan akımı enfeksiyonuydu. Kateter ilişkili kan akımı enfeksiyonu açısından bölgeler arasında anlamlı fark görülmedi (p>0,05). Kateter kalış süresinin ve hastanede yatış süresinin uzaması ile enfeksiyon gelişme riskinin arttığı tespit edildi (p>0,05).Sonuç: Çocuk hastalarda santral venöz kateter uygulamasına bağlı komplikasyon gelişimi söz konusu olsa da, santral venöz kateter uygulaması güvenilir bir girişimdir. Femoral ve juguler bölgelerde girişime bağlı ciddi komplikasyonların subklavyen...

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Accidental placement of central venous catheter in lung parenchyma causing hydrothorax

Cited by 6 publications

References 6 publications

Management of Parenteral Nutrition in Hospitalized Adult Patients

Management of Parenteral Nutrition in Hospitalized Adult Patients

Hydrothorax caused by catheter malposition misdiagnosed via using plain radiography

Evaluation of Central Venous Catheterization Complications and Related Risk Factors in a Pediatric Intensive Care Unit

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