Catheter Malposition as a Considerable Complication of Central Venous Catheterization: An Analysis of 23 Cases in a Tertiary Referral Hospital

Objectives: We aimed to present the clinical characteristics of patients with catheter malposition following central venous catheterization, and to review the relevant literature. Materials and Methods: A total of 1816 patients who underwent central venous catheterization via internal jugular or subclavian vein in a tertiary referral hospital between January 2011 and December 2018 were researched for this cross-sectional study. Among them, procedure-related catheter malposition was detected in 23 cases, and the study population composed of these cases with catheter malposition. Medical data of study population were obtained and retrospectively reviewed. Results: The rate of catheter malposition following central venous catheterization was 1.26%. The mean age of the study population was 55.1±21.3 years, and 52.2% of them were male. The blind-landmark technique without ultrasound guidance was the selected approach in 21 of cases (91.3%). In study population, additional procedure-related complications were subcutaneous hematoma, pneumothorax, and hemo-pneumothorax in six, three and two cases, respectively. In-hospital death was observed in two cases because of the causes other than procedure-related complications. Conclusion: Catheter malposition is a relatively lesser encountered but an important complication of central venous catheterization. We suggest that during central venous catheterization, the radiological-guided approach should be of choice instead of the blind-landmark technique to minimize the risk of catheter malposition.