ABSTRACT
Abstract Background and objectives Ultrasound-guided internal jugular vein catheterization is a common and generally safe procedure in the operating room. However, inadvertent puncture of a noncompressible artery such as the subclavian artery, though rare, may be associated with life-threatening sequelae, including hemomediastinum, hemothorax, and pseudoaneurysm. Case report We describe a case of the successful endovascular repair of right subclavian artery injury in a 75-year-old woman. Subclavian artery was injured secondary to ultrasound-guided right internal jugular vein catheterization under general anesthesia for orthopedic surgery. Conclusion Under general anesthesia several factors such as hypotension can mask the signs of subclavian artery injury. This case report indicates that clinicians should be aware of the complications of central venous catheterization and take prompt action.
Resumo Justificativa e objetivos A cateterização da veia jugular interna guiada por ultrassom é um procedimento comum e geralmente seguro em sala cirúrgica. No entanto, a punção inadvertida de uma artéria não compressível, como a artéria subclávia, embora rara, pode estar associada a sequelas e risco para vida, incluindo hemomediastino, hemotórax e pseudoaneurisma. Relato de caso Descrevemos um caso bem-sucedido da correção endovascular de lesão da artéria subclávia direita em uma paciente de 75 anos. A artéria subclávia foi lesionada após cateterização guiada por ultrassom da veia jugular interna direita sob anestesia geral para cirurgia ortopédica. Conclusão Sob anestesia geral, vários fatores, como a hipotensão, podem mascarar os sinais de lesão da artéria subclávia. Este relato de caso indica que os médicos devem estar cientes das complicações da cateterização venosa central e tomar medidas imediatas.
Subject(s)
Humans , Female , Aged , Subclavian Artery/injuries , Catheterization, Central Venous/adverse effects , Vascular System Injuries/etiology , Endovascular Procedures/methods , Catheterization, Central Venous/methods , Ultrasonography, Interventional/methods , Orthopedic Procedures/methods , Jugular Veins/diagnostic imagingABSTRACT
Objective To explore the most effective formula to predict the catheterization length of the right internal jugular vein by an-terior approach. Methods Sixty-seven cases performed with right internal jugular vein catheterization from January 2013 to June 2013 were enrolled in this study and 4 formulas were selected to predict the catheterization lengths. Comparing their predicted lengths with the actual lengths defined as the lengths of the internal catheters which terminals were inserted to a accurate position,and analyse their predictive validi-ty. Results The predictive error percentages of the 4 formulas were all less than 15%. Comparing the predicted lengths and the actual lengths, there was no difference between the predicted length of the 1st formula and the actual one(P>0. 05),and the predicted lengths of the other three formulas were significantly less than the actual ones(P0. 05). Conclusion The predictive error of all the 4 formulas is less than 15%, and the 1st formula is simple,practical and associated with a much smaller error,more suitable to estimate the length of the right internal jugular vein catheterization by anterior approach.
ABSTRACT
Internal jugular vein catheter is frequently used for emergency hemodialysis. Various complications have been reported. Infection is one of the problem after long term use. There have been reports of osteomyelitis of clavicle secondary to subclavian catheterization but not osteomyelitis associated with internal jugular vein catheterization. There are two possible pathways of infection. One is hematogenous spread from another focus in the body or sepsis. The other is transmission of focal infection. Manipulation of the needle may perforate the vein and produce hematoma. The infected hematoma may have resulted in abscess formation around the rib and subsequent osteomyelitis. Herein we report a case of osteomyelitis of the rib complicating internal jugular vein catheterization with a review of the literature.
Subject(s)
Abscess , Catheterization , Catheters , Clavicle , Emergencies , Focal Infection , Hematoma , Jugular Veins , Needles , Osteomyelitis , Renal Dialysis , Ribs , Sepsis , VeinsABSTRACT
Cannulation of the internaliugular vein was first described by English et al in l969; since then, it has steadily increased in popularity to its present position as one of the methods of choise for CVP monitorimg. But this method of CVP monitoring has some potential compolication such as infection, thrombophlebitis, pneumothorax, hydrothorax, hematoma, air embolism, catheter shearing, nerve injuries & pericardial tamponade, etc. We experienced a case of hydrothorax following internal jugular vein catheterization.
Subject(s)
Cardiac Tamponade , Catheterization , Catheters , Embolism, Air , Hematoma , Hydrothorax , Jugular Veins , Pneumothorax , Thrombophlebitis , VeinsABSTRACT
Cannulation of the internaliugular vein was first described by English et al in l969; since then, it has steadily increased in popularity to its present position as one of the methods of choise for CVP monitorimg. But this method of CVP monitoring has some potential compolication such as infection, thrombophlebitis, pneumothorax, hydrothorax, hematoma, air embolism, catheter shearing, nerve injuries & pericardial tamponade, etc. We experienced a case of hydrothorax following internal jugular vein catheterization.