Repeated Hemothorax Following Ipsilateral Left Internal Jugular and Left Subclavian Venous Catheterization(Olgu Bildirimi)

Year 2005, Volume: 22 Issue: 3, 131 - 134, 31.12.2009

F. Ülger, B. Sarıhasan A. Şenel

Abstract

Aynı Taraf Sol İnternal Jugular ve Subklavian Venöz Kateterizasyondan Sonra Tekrarlayan Hemotoraks
Kritik hastada en sık kullanılan invaziv girişimlerden birisi de santral kateterizasyon işlemidir. Kateterizasyon sıklıkla internal juguler ve subklavian vene uygulanır. Bu venler hemo-dinamik monitorizasyona izin verdiği gibi ilaç ve sıvı tedavileri, kan transfüzyonu ve total pa-renteral beslenmeye için de olanak sağlar. Komplikasyonlar internal juguler vende %1-4 sıklıkla arter delinmesi ve subklavian girişimlerde %1-5 sıklıkla hemotoraks ve hidrotorakstır. Bizim hastamızda ilk girişimde yerleştirilen internal juguler ven kateteri hemotoraksa yol açmıştır. Yoğun bakım koşullarında sol subklavian vene yerleştirilen kateter toraks içerisine yerleştirilmiştir. Sonuç olarak internal jugular ve subklavian venöz kateterizasyonun mekanik komplikasyonları benzer riskler taşımaktadır ve aynı taraftan çoklu kateterizasyon girişimlerinde komplikasyon olasılığı artabilmektedir.



Central venous catheterization is one of the most commonly used invasive procedures in c ritic ally ill patients. The most frequent sites of cannulation are the internal jugular and subclavian veins. They permit hemodynamic monitoring and allow access for the administratio n of fluids, blood products, medications, and total parenteral nutrition (TPN). Complications include arterial puncture with the internal jugular approach (0.1 to 4%) and pneumothorax or hemothorax with the subclavian approach (1 to 5%). Our patient with left internal juguler vein catheterization was complicated with hemothorax in the first cannulation application in operation. Left subclavian vein was cannulated in the intensive care unit and catheter was placed into the thorax. Overall, internal jugular and subclavian venous catheterization carry similar risks of mechanical complications as multiple cannulation applications in ipsilateral side, might increase complication rate.

Keywords

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