Mechanical complications and malpositions of central venous cannulations by experienced operators

Schummer, Wolfram; Schummer, Claudia; Rose, Norman; Niesen, Wolf‐Dirk; Sakka, Samir G.

doi:10.1007/s00134-007-0560-z

Cited by 162 publications

(152 citation statements)

References 21 publications

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“…Complications are higher after two unsuccessful cannulation attempts. 8 Compared with landmark method, real time ultrasound guidance for cannulation of internal jugular veins is associated with higher success rate, fewer mechanical complications and shorter time for cannulation both in adults and infants. 3,9 So, real time ultrasound guidance was used in all three cases.…”

Section: Discussionmentioning

confidence: 99%

Procedural sedation with dexmedetomidine for ultrasound guided central venous cannulation in agitated, high risk critically ill patients. A series of three cases

Shrestha

Parajuli

Bhattarai

2017

Bangladesh Crit Care J

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Central venous cannulation is a commonly performed procedure in ICU. Even in the experienced hands, it is not free of complications. Acute mechanical adverse events are more likely in agitated and uncooperative patients. Ultrasound guided cannunation of internal jugular vein is associated with higher success rate and fewer mechanical complications when compared with traditional techniques. Dexmedetomidine has been used as a safe and effective agent for procedural sedation in a wide variety of patients. Here we successfully used dexmedetomidine for ultrasound guided central venous cannulation of internal jugular vein in uncooperative high risk patients, even at the extremes of age.Bangladesh Crit Care J March 2017; 5(1): 68-69

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Section: Discussionmentioning

confidence: 99%

Procedural sedation with dexmedetomidine for ultrasound guided central venous cannulation in agitated, high risk critically ill patients. A series of three cases

Shrestha

Parajuli

Bhattarai

2017

Bangladesh Crit Care J

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“…Schummer and colleagues [2] reported a 6.7% rate of malpositioning in a large prospective study that included more than 1700 catheterizations. Almost a third of the malposition cases involved left internal jugular vein (LIJV) cannulation [2]. When the frequency of malpositioning of the right internal jugular vein (RIJV) is compared with that of the LIJV, the rate is 4.3% versus 12%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…It is clear that some insertion sites are involved in malpositioning more often than others, as reported in observational studies [1,2,17,18]. The true incidence of CVC malpositions is unknown and might be higher than described.…”

mentioning

confidence: 92%

Are we underestimating the frequency of malpositioned central venous catheters inserted via the left internal jugular vein? A case report and short review of literature

et al. 2010

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AbstractCentral venous cannulation is a widely used procedure in clinical medicine. Central venous catheters are inserted most often via the internal jugular and subclavian veins. One of the complications is malpositioning of the catheter, and some insertion sites carry a higher risk for that occurrence. We report a case of a malpositioned central venous catheter inserted via the left internal jugular vein in a patient with a ruptured diaphragm. Our objectives were to review the venous anatomy of the chest and the literature reporting malpositioned central venous catheters and to discuss the approach through the left internal jugular vein. Left internal jugular cannulation could carry a higher rate of malposition than reported, and anatomy gives a possible, simple answer. Contrast enhancement, although central venous catheters are radiopaque, is helpful when an approach through the left internal jugular vein is used and difficulties are encountered during insertion.

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“…If overlooked they can result in false central venous pressure reading, unsatisfactory infusion rate, and vessel erosion or even rupture, venous thrombosis and retrograde infusion into cranium. Venous malpositioning is more frequent in left sided lines and hence usually avoided [5,6]. Our patient already had a dialysis access placed in right IJV so left sided IJV was used for access.…”

Section: Case Historymentioning

confidence: 91%

Accidental Catheterization of Left Partial Anomalous Pulmonary Venous Connection (PAPVC): A Rare Instance of Central Venous Access Malpositioning

Talukder¹

2017

AJCTS

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Central venous catheter (CVC) is one of the most commonly placed invasive devices in critical care setup. Its placement can be associated with many technical complications like bleeding, pneumothorax, arterial puncture and infection. Furthermore technical and anatomical variations, unfavorable body habitus can lead to malpositioning of CVC within venous system even when they are placed under radiological guidance. If not addressed timely, malpositioning can be associated with poor catheter functioning and serious complications like vessel erosion, bleeding, thrombosis. Presence of congenital venous anomalies can be a rare cause of CVC malpositioning. We report a case of young female in whom CVC placed through left internal jugular venous (IJV) route accidentally entered into a left upper pulmonary vein through partial anomalous pulmonary venous connection (PAPVC) with the left brachiocephalic vein. Post insertion chest radiograph showed unusual curvilinear course of the left IJV access towards left pulmonary hilum. The diagnosis was clinched after contrast enhanced computed tomography delineated the previously undiagnosed venous anomaly in the patient. There is no report of CVC malposition into the pulmonary vein in medical literature making it unique and first of its kind. Malpositioned CVC can thus lead to revelation of asymptomatic congenital vascular anomalies in a completely unrelated clinical setting.

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Mechanical complications and malpositions of central venous cannulations by experienced operators

Abstract: Even experienced operators cause a considerable number of early mechanical complications and malpositions. After two unsuccessful cannulation attempts failure and associated complications are very likely.

Cited by 162 publications

References 21 publications

Procedural sedation with dexmedetomidine for ultrasound guided central venous cannulation in agitated, high risk critically ill patients. A series of three cases

Procedural sedation with dexmedetomidine for ultrasound guided central venous cannulation in agitated, high risk critically ill patients. A series of three cases

Are we underestimating the frequency of malpositioned central venous catheters inserted via the left internal jugular vein? A case report and short review of literature

Accidental Catheterization of Left Partial Anomalous Pulmonary Venous Connection (PAPVC): A Rare Instance of Central Venous Access Malpositioning

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