scholarly journals Mediastinal contrast extravasation after injection via central venous catheter with follow-up venography: a case report

2021 ◽  
Vol 90 (3-4) ◽  
pp. 173-177
Author(s):  
Marko Kastelic ◽  
Igor Kocijančič ◽  
Dašmir Nuredini ◽  
Jernej Vidmar
Keyword(s):  
Case Report ◽  
Central Venous Catheter ◽  
Rare Complication ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
High Flow ◽  
Contrast Injection ◽  
Central Venous ◽  
Contrast Extravasation

A central venous catheter can occasionally be used for contrast injection during a CT scan, with mediastinal contrast extravasation as a possible rare complication in this setting. According to the published cases, interventional venography has never been performed to assess the venous system directly. We present a case of mediastinal contrast extravasation with follow-up venography, which clearly depicted a subintimal leak and no evidence of sustained extravasation. The contrast was reabsorbed shortly after the extravasation with no adverse effects for the patient. The presented case illustrates the importance of recognition of proper positioning of central venous catheters before performing angiographies with relatively high flow velocity, such as CT angiography, as well as the importance of performing staff being familiar with different aspects of working with central venous catheters.

scholarly journals Rare complication of central venous catheter placement: bilateral hydrothorax

2018 ◽  
Vol 11 (1) ◽  
pp. e226699
Author(s):  
Guntug Batihan ◽  
Kenan C Ceylan ◽  
Seyda Ors Kaya
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Clinical Medicine ◽  
Rare Complication ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Safe Procedure ◽  
Central Venous ◽  
Central Venous Catheter Placement ◽  
Intensive Care Patients

Central venous catheters (CVCs) are very useful tools in clinical medicine. It is important not only for the administration of medications or fluids but also the measurement of haemodynamic variables, especially in intensive care patients. CVC placement is a relatively safe procedure but may occasionally be associated with complications, such as pneumothorax, haemothorax, cardiac tamponade, sepsis and thrombosis. We aim to report an extraordinary case of bilateral hydrothorax due to CVC placement.

A Stuck Hemodialysis Central venous Catheter

2008 ◽  
Vol 9 (4) ◽  
pp. 301-303 ◽  
Author(s):  
M. Field ◽  
J. Pugh ◽  
J. Asquith ◽  
S. Davies ◽  
A.D. Pherwani
Keyword(s):  
Case Report ◽  
Central Venous Catheter ◽  
Vascular Access ◽  
Insertion Site ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Central Venous

Background A growing number of hemodialysis patients are dependent upon central venous catheters (CVCs) for long-term vascular access. Although many complications of CVCs have been documented, the phenomenon of the stuck catheter is described relatively infrequently. Case report We describe a case where attempts to remove the line by exploration of the jugular insertion site in theater were unsuccessful and the line was internalized. Discussion The case is then discussed with all available cases in the literature to suggest principles of managing and preventing the stuck catheter phenomenon.

scholarly journals Cardiac tamponade: a rare complication of central venous catheter – a clinical case report

2018 ◽  
Vol 68 (1) ◽  
pp. 104-108
Author(s):  
Ana Catarina Azevedo ◽  
Isabel Flor de Lima ◽  
Vânia Brito ◽  
Maria João Centeno ◽  
Antero Fernandes
Keyword(s):  
Case Report ◽  
Central Venous Catheter ◽  
Cardiac Tamponade ◽  
Clinical Case ◽  
Rare Complication ◽  
Venous Catheter ◽  
Central Venous

A bedside rescue method for retrieving retained guidewires: The ‘Suck Out’ technique

2020 ◽  
pp. 112972982094345
Author(s):  
Maryanne Z A Mariyaselvam ◽  
Vikesh Patel ◽  
Adam Sawyer ◽  
James A Richardson ◽  
Jonathan Dean ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Patient Harm ◽  
Central Venous ◽  
Exact Test ◽  
The United Kingdom ◽  
Catheter Tip ◽  
Never Event ◽  
Benchtop Model

Background: Central venous catheter guidewire retention is classed as a ‘never event’ in the United Kingdom, with the potential for significant patient harm. If the retained guidewire remains within the central venous catheter lumen, bedside techniques may facilitate guidewire retrieval. However, these techniques may be ineffective if the guidewire has already passed below skin level. We investigated a novel ‘suck out’ technique for bedside guidewire retrieval and compared this against traditional retrieval methods. Methods: Simulation 1: in a benchtop model, seven different central venous catheters had their corresponding guidewire placed in the last 2 cm of the catheter tip which was immersed horizontally in fluid. A 50-mL syringe was attached to the distal lumen central venous catheter hub and suction applied for 5 s, and the distance of guidewire retraction was recorded. Simulation 2: a central venous catheter guidewire was intentionally retained within the catheter at either 5 cm above or below skin level in a pigskin model. Simple catheter withdrawal, catheter clamping withdrawal and the ‘suck out’ method were compared for efficacy using Fisher’s exact test. Results: Simulation 1: retained guidewires were retracted by 13 cm on average. Simulation 2: when guidewires were retained 5 cm above skin level, all retrieval methods were 100% effective; however, when retained 5 cm below skin level, simple catheter withdrawal was ineffective, clamping and withdrawal was only 10% effective and the ‘suck out’ technique was 90% effective (p < 0.001). Conclusion: The ‘suck out’ technique can effectively retract guidewires retained within central venous catheter lumens and demonstrates superiority over traditional methods of retained guidewire extraction in simulated models.

scholarly journals Incidence of bloodstream infection among patients on hemodialysis by central venous catheter

2010 ◽  
Vol 18 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Cibele Grothe ◽  
Angélica Gonçalves da Silva Belasco ◽  
Ana Rita de Cássia Bittencourt ◽  
Lucila Amaral Carneiro Vianna ◽  
Ricardo de Castro Cintra Sesso ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Severe Infection ◽  
Venous Catheter ◽  
Central Venous Catheter Insertion ◽  
Central Venous ◽  
Double Lumen ◽  
One Year ◽  
Very High

This study evaluated the incidence and risk factors of bloodstream infection (BSI) among patients with a double-lumen central venous catheter (CVC) for hemodialysis (HD) and identified the microorganisms isolated from the bloodstream. A follow-up included all patients (n=156) who underwent hemodialysis by double-lumen CVC at the Federal University of São Paulo - UNIFESP, Brazil, over a one-year period. From the group of patients, 94 presented BSI, of whom 39 had positive cultures at the central venous catheter insertion location. Of the 128 microorganisms isolated from the bloodstream, 53 were S. aureus, 30 were methicillin-sensitive and 23 were methicillin-resistant. Complications related to BSI included 35 cases of septicemia and 27 cases of endocarditis, of which 15 cases progressed to death. The incidence of BSI among these patients was shown to be very high, and this BSI progressed rapidly to the condition of severe infection with a high mortality rate.

Risk factor identification and predictive models for central line requirements for patients on vasopressors

2021 ◽  
pp. 0310057X2110242
Author(s):  
Adrian D Haimovich ◽  
Ruoyi Jiang ◽  
Richard A Taylor ◽  
Justin B Belsky
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Logistic Regression ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Single Agent ◽  
Composite Endpoint ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Central Venous

Vasopressors are ubiquitous in intensive care units. While central venous catheters are the preferred route of infusion, recent evidence suggests peripheral administration may be safe for short, single-agent courses. Here, we identify risk factors and develop a predictive model for patient central venous catheter requirement using the Medical Information Mart for Intensive Care, a single-centre dataset of patients admitted to an intensive care unit between 2008 and 2019. Using prior literature, a composite endpoint of prolonged single-agent courses (>24 hours) or multi-agent courses of any duration was used to identify likely central venous catheter requirement. From a cohort of 69,619 intensive care unit stays, there were 17,053 vasopressor courses involving one or more vasopressors that met study inclusion criteria. In total, 3807 (22.3%) vasopressor courses involved a single vasopressor for less than six hours, 7952 (46.6%) courses for less than 24 hours and 5757 (33.8%) involved multiple vasopressors of any duration. Of these, 3047 (80.0%) less than six-hour and 6423 (80.8%) less than 24-hour single vasopressor courses used a central venous catheter. Logistic regression models identified associations between the composite endpoint and intubation (odds ratio (OR) 2.36, 95% confidence intervals (CI) 2.16 to 2.58), cardiac diagnosis (OR 0.72, CI 0.65 to 0.80), renal impairment (OR 1.61, CI 1.50 to 1.74), older age (OR 1.002, Cl 1.000 to 1.005) and vital signs in the hour before initiation (heart rate, OR 1.006, CI 1.003 to 1.009; oxygen saturation, OR 0.996, CI 0.993 to 0.999). A logistic regression model predicting the composite endpoint had an area under the receiver operating characteristic curve (standard deviation) of 0.747 (0.013) and an accuracy of 0.691 (0.012). This retrospective study reveals a high prevalence of short vasopressor courses in intensive care unit settings, a majority of which were administered using central venous catheters. We identify several important risk factors that may help guide clinicians deciding between peripheral and central venous catheter administration, and present a predictive model that may inform future prospective trials.

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