Central Venous Catheter Malposition: Two Case Reports

Yıl 2019, Cilt: 1 Sayı: 2, 91 - 94, 03.09.2019

Semih Aydemir Yavuz Katırcı

Öz

Introduction: Unintended vessel advancement during central venous
catheter (CVC) insertion is a rare but serious complication.  To reduce the complications whileCVC
placement, the practitioner should be experienced. After the placement it is
required to verify correctness.

Case Presentation:

·        
Case
1: A 65-year-old
male patient who returned as hypotensive after cardiopulmonary resuscitation
was planned with CVC insertion formonitoring central venous pressure, fluid
replacement and inotropic support. As the patient’s hemostatic parameterswere
normal, catheter was placed into the right subclavian vein. Posterior-anterior
chest radiograph(CR) was used to confirm catheterization site. It was found
that catheter tip was not in normal position, right internal jugular vein(IJV)
was directed and twisted in two places.

·        
Case
2:A 64-year-old
patient with respiratory distress was conscious of consciousness. The patient’s
hemostasis parameters were normal and was placed central catheter into right
internal jugular vein (IJV). It was seen by theCR that catheter tip was not in
the correct position and it was directed to the right subclavian vein.

Discussion: One of the most common complications during CVC
placement is malposition of the catheter. Placing a CVC is an invasive
procedure and it should be remembered that various complications may develop
during or after the placement.Moreover, practitioners should remember that
malposition may not be noticed if no imaging and checking methods are used
during CVC administration.

Conclusion:It is important that the accuracy of the position of
the CVC should be confirmed with post-procedure CR. Thus, any complications
that require emergent intervention like malposition or pneumothorax can be
detected early. 

Anahtar Kelimeler

Central venous catheter, malposition

Kaynakça

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