ABSTRACT
El cateterismo de venas centrales es una técnica de uso muy frecuente, aunque las complicaciones de los catéteres centrales pueden ser múltiples y, en ocasiones, fatal. Presentamos un caso de taponamiento cardiaco por nutrición parenteral pocas horas después de la movilización de un catéter central de acceso periférico colocado días antes. El diagnóstico fue realizado por ecocardiografía, y se realizó una pericardiocentesis urgente, logrando la recuperación total de la paciente. Los catéteres centrales de acceso periférico son más susceptibles de movilización por los movimientos del brazo del paciente, por lo que es importante utilizar catéteres blandos, asegurarse de que la punta se encuentra por encima de la carina para evitar perforaciones de la reflexión pericárdica y realizar una buena fijación a la piel. El diagnóstico debe hacerse lo antes posible, dada la elevada mortalidad de esta complicación, y la herramienta diagnóstica esencial es la ecocardiografía. El tratamiento consiste en la retirada del catéter y la pericardiocentesis urgente (AU)
Central venous catheterization is a very common technique, although its complications can be multiple and sometimes fatal. A case is presented of cardiac tamponade by parenteral nutrition a few hours after moving a central venous catheter peripherally inserted a few days before. The diagnosis was made by echocardiography, and an emergency pericardiocentesis was performed, achieving complete recovery of the patient. Peripherally inserted central venous catheters are more likely to change their position secondary to the movements of the patients arm, thus it is important to use soft catheters, make sure the tip lies above the carina to avoid perforation of the pericardial reflexion, and fix it well to the skin. Diagnosis must be made as soon as possible, given the high mortality rate of this complication, and the essential diagnostic tool is echocardiography. Elective treatment consists of early catheter withdrawal and emergency pericardiocentesis (AU)
Subject(s)
Humans , Female , Middle Aged , Cardiac Tamponade/etiology , Catheterization, Central Venous/adverse effects , Pericardiocentesis/methods , Central Venous Catheters/adverse effects , Parenteral Nutrition, Total , Equipment FailureABSTRACT
Central venous catheterization is a very common technique, although its complications can be multiple and sometimes fatal. A case is presented of cardiac tamponade by parenteral nutrition a few hours after moving a central venous catheter peripherally inserted a few days before. The diagnosis was made by echocardiography, and an emergency pericardiocentesis was performed, achieving complete recovery of the patient. Peripherally inserted central venous catheters are more likely to change their position secondary to the movements of the patient's arm, thus it is important to use soft catheters, make sure the tip lies above the carina to avoid perforation of the pericardial reflexion, and fix it well to the skin. Diagnosis must be made as soon as possible, given the high mortality rate of this complication, and the essential diagnostic tool is echocardiography. Elective treatment consists of early catheter withdrawal and emergency pericardiocentesis.
Subject(s)
Cardiac Tamponade/etiology , Catheterization, Central Venous/instrumentation , Catheters/adverse effects , Equipment Failure , Female , Humans , Middle AgedABSTRACT
Epidermolysis bullosa encompasses a group of rare clinical profiles marked by the formation of bullae on the skin and mucosa as the result of slight mechanical trauma. The anesthesiologist must take certain safety measures to monitor the airway and must expect difficult venous access in patients with this disease. We report our experience in providing anesthesia by various techniques for plastic and maxillofacial surgery. Most anesthetic techniques can be considered safe if they are performed with care and attention to detail.
