Subclavian vein cannulation: a new complication.

Abstract

TABLE II-Mean (± SE of mean) plasma urate concentrations (mmol/l) in patients who suffered AMI according to whether they were given diuretics Day: 1 4 7 14 Diuretics given (n = 38) 0-354 ± 0-015 0 409 ±0-021 * 0-392 +0-018 0-382 ±0-016 Diuretics not given (n = 32) 0 340 ±0-012 0-327 0-015* 0-368 ±0-018 0-368 0-018 *P<0-01. ate concentrations, may play a part in altering the renal handling of urate. These organic acids are thought to share a common secretory mechanism with urate and produce hyperuricaemia by competing with urate for this secretory site.11 12 Possibly also a more rapid turnover of preformed purines or increased de novo synthesis may have produced hyperuricaemia in the AMI group. Further study is in progress to elucidate the mechanism. We thank the physicians of Addenbrooke's Hospital, Cambridge, for allowing us to study patients under their care and Professor H Lehmann for the laboratory facilities. P G was the holder of the Grimshaw-Parkinson Research Studentship at the University of Cambridge and is at present receiving a grant from the Wellcome Trust. Requests for reprints should be addressed to P G

Central venous catheterization—An anatomical review of a clinical skill—Part 1: Subclavian vein via the infraclavicular approach

“…The hydrothorax may be bilateral because of the presence of congenital or acquired interpleural communications (Sheep and Guiney, 1982). Allsop and Askew (1975) reports a case of actual cannulation of the pleural space. This should be recognized at the time of insertion by failing to aspirate blood as the cannula is advanced and by lowering the whole infusion set below the level of the patient to observe the reflux of blood up the cannula.…”

“…Complications of a malpositioned catheter may result in a hydrothorax, hemothorax, ascites (Allsop and Askew, 1975), chest wall abscess (Oakes and Wilson, 1975) (reported in a patient with long term catheterization and administration of total parenteral nutrition), chest pain (Webb et al, 1986), and embolization to the pleural space (Hegarthy, 1977).…”