Vascular erosion by central venous catheters used for total parenteral nutrition

Walshe, Criona M; Phelan, Dermot; Bourke, Jane E.; Buggy, Donal J.

doi:10.1007/s00134-006-0507-9

Cited by 70 publications

(69 citation statements)

References 13 publications

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“…Among the delayed complications, delayed vascular perforation by CVC is a rare but life-threatening complication (2,(8)(9)(10). Leftsided approach, large diameter catheters and old age were known as the risk factors for delayed vascular perforation (4,8).…”

Section: Discussionmentioning

confidence: 99%

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Sudden hypotension occurring after 4 days of left-sided central catheter placement

Kim

2017

J. Thorac. Dis.

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Central venous catheters (CVCs) have an important role in the management of critically ill patients. In contrast to the immediate complications after CVC insertion, the late complications were difficult to be noticed without high suspicion despite their life-threatening outcome. We report a rare but fatal delayed vascular perforation occurring after 4 days of left-sided hemodialysis catheter insertion. A 74-year-old male with septic shock was treated with continuous renal replacement therapy (CRRT) and recovered smoothly during hospitalization. Refractory hypotension occurred abruptly on the fourth hospital day. Chest X-ray and computed tomography revealed that the catheter tip perforated the innominate vein and located the mediastinum. He finally died despite the emergent radiologic intervention.

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Section: Discussionmentioning

confidence: 99%

“…The left-sided catheter may move with changes in patient's position, which result the tip to be perpendicular to the vascular wall and cause vascular erosion (2,8).…”

Section: Discussionmentioning

confidence: 99%

Sudden hypotension occurring after 4 days of left-sided central catheter placement

Kim

2017

J. Thorac. Dis.

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“…Despite the advances in the design, material, and technique of insertion of the catheter, there are several reports in the literature describing secondary perforation of the catheter tip through the vessel wall, causing paravenous infusion or bleeding into the pleural cavity or the mediastinum. [3][4][5][6] There are several reports also describing bilateral hydrothoraxes, with or without an additional hydromediastinum after the catheter had perforated the vessel wall. 7,8 Accidental retraction of CVCs are quite common in ICU patients; however, to our knowledge only one case has been reported in the literature in which an accidental retraction of a CVC might have led to a hydrothorax.…”

Section: Discussionmentioning

confidence: 99%

“…There are few reports of paravenous infusion of TPN into the pleural cavity, and most of them are associated with punctures of the internal jugular veins, predominantly on the left side. 5,7,11 To discriminate between a chylothorax and a hydrothorax caused by a paravenous infusion, some authors recommended chemical analysis of that fluid. 7,8 Also, comparing blood and fluid glucose, especially when the effusion is suspected to be TPN, is an option of narrowing the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Hydrothorax After Retraction of a Subclavian Central Venous Catheter

et al. 2012

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“…Ancak venöz perforasyon bile %0,5'in altında görülmektedir. 13 Katetere bağlı vasküler perforasyon işlemden ortalama 2 gün sonra görülür ve %74 oranında sol internal jugüler ve sol subklaviyen girişim sonrası oluşur. En sık komplikasyon ise plevral efüzyondur.…”

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A Rare and Dangerous Complication of Central Venous Catheterization: Intimal Injury

Akkuzu¹,

Kalkan²,

Durgun³

et al. 2017

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Santral venöz kateterler acil hasta resüsitasyonunda ve uzun süreli damar içi yol gereksinimlerinde sıkça kullanılmaktadır. Ancak kateterlerin yerleştirilmesi sırasında veya sonrasında gelişen komplikasyonlar nedeniyle hasta zarar görebilmekte veya ek girişim yapılmasına neden olunabilmektedir. Kateter malpozisyonu, arter ponksiyonu, hemotoraks veya pnömotoraks gibi çeşitli mekanik komplikasyonlar hastaların %5-19'unda görülebilir ve erken tanısı yaşamsal öneme sahiptir. Burada kateter takılmasının ikinci gününde belirgin hipoksemiye neden olan plevral efüzyonla ortaya çıkan süperior vena kavada intimal yaralanma olgusu sunulmuştur. Anahtar Kelimeler: İntimal yaralanma, mekanik komplikasyon, plevral efüzyon, santral venöz kateter Central venous catheters are frequently used for urgent patient resuscitation and for prolonged intravenous route requirements. However, the patient may be injured or may need additional intervention due to complications associated with catheter insertion. Various mechanical complications such as catheter malposition, arterial puncture, hemothorax and pneumothorax can be seen in 5-19% of patients and early recognition has a vital effect. Here, we present a case of pleural effusion leading to significant hypoxemia due to intimal injury to the superior vena cava which developed in the second day of catheter insertion. Keywords: Intimal injury, mechanical complication, pleural effusion, central venous catheter Burada yoğun bakım ünitemize solunum yetmezliği kliniğinde entübe olarak kabul edilen uygun mekanik ventilatör ayarlarında solutulmasına rağmen hayatı tehdit edici boyutta hipoksemisi gelişen ve ilk değerlendirmeler sonucunda SVK'ye bağlı süperior vena kavada intimal yaralanma ve buna bağlı masif plevral efüzyon saptanarak tedavi edilen 5,5 aylık erkek hasta sunulmuştur. Öz Abstract Giriş

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Vascular erosion by central venous catheters used for total parenteral nutrition

Abstract: In patients receiving total parenteral nutrition via central venous catheters, erosion has an incidence per catheter of 0.17% and is more likely to occur in left-sided catheters and elderly patients.

Cited by 70 publications

References 13 publications

Sudden hypotension occurring after 4 days of left-sided central catheter placement

Sudden hypotension occurring after 4 days of left-sided central catheter placement

Hydrothorax After Retraction of a Subclavian Central Venous Catheter

A Rare and Dangerous Complication of Central Venous Catheterization: Intimal Injury

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