Journal of Medical and Surgical Intensive Care Medicine 2010 , Vol 1, Issue 3
Mechanical Complications Related to Central Venous Catheterization: Lessons to be Learned From Two Cases
Cemal Kızılarslanoğlu 1 , Mine Durusu Tanrıöver 1 , Begüm Ergan Arsava 2 , Barbaros Çil 3 , Arzu Topeli İskit 4
1Hacettepe Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Ankara, Turkey
2Hacettepe Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Turkey
3Hacettepe Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Ankara, Turkey
4Hacettepe Üniversitesi Tıp Fakültesi, İç Hastalıkları Yoğun Bakım Ünitesi, Ankara, Turkey

Central venous catheterization (CVC) is an interventional technique which is frequently used in critical patient care for diagnosis and treatment. As in all interventional procedures, CVC may be associated with both short and long-term complications. Here, we report two cases to demonstrate infrequent, but possible causes of mechanical complications related to CVC. The first case was a 24-year-old man with non-Hodgkin lymphoma who initially underwent femoral vein, then internal jugular vein (IJV) catheterization. A forgotten guide wire extending from the left femoral vein to the right IJV was noticed several days after the femoral venous catheterization during an attempt at an IJV catheterization. In the second case, who was a 71-year-old woman requiring CVC for hemodialysis and monitorization, the tip of a left IJV catheter, inserted after several attempts, was found in the right IJV. These cases illustrate the importance of obtaining and appropriately evaluating radiograms after venous catheterization, while bearing the possible mechanical complications in mind.

Keywords : Central venous catheterization, mechanical complication, malposition, critical care