Cardiac Tamponade Occurred during Subclavian Venous Catheterization / 대한마취과학회지

ABSTRACT

There have been numerous reports of complications associated with central venous catheterization. These are pneumothorax, hemothorax, nerve injury, and so on. These complications can occur more frequently with the subclavian approach than with the internal jugular approach in inexperienced hands. We report a rare complication, cardiac tamponade, which occurred during subclavian venous catheterization. A 44 year-old woman was scheduled for left pneumonectomy due to a tuberculosis destroyed lung. The first trial of subclavian venous catheterization was failed because of the arterial puncture. The internal jugular vein was cannulated successfully. Just after catheterization, sudden hypotension and tachycardia developed and persisted with vasopressors. An emergent left thoracotomy and pericardiostomy to evacuate massive hematoma confirmed the diagnosis, cardiac tamponade. This case suggests that central catheterization should be done carefully and it is better to avoid using the subclavian vein when there is radiological evidence of abnormal cardiac anatomy or great vessels due to a destroyed lung.