Tashjian Brian C, Schoor Michael E, Grant Masilo
From the Department of Anesthesiology and Perioperative Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
A A Pract. 2019 Feb 15;12(4):122-124. doi: 10.1213/XAA.0000000000000956.
We present a central venous catheter misplacement case. A left internal jugular vein percutaneous introducer was inserted for fluid resuscitation with a single-lumen infusion catheter placed through the lumen for medication infusions. Placement was performed under ultrasound guidance, with confirmation of the wire within the venous lumen. Radiographs suggested that the introducer had perforated the innominate vein. Contrast was injected through the single-lumen infusion catheter and showed cannulation of the left internal mammary vein. The link between portal hypertension and increased risk of central line misplacement as well as diagnosis and potential methods to avoid this rare complication are discussed.
我们报告一例中心静脉导管误置病例。为进行液体复苏，经皮插入了一根左颈内静脉穿刺导引器，并通过其管腔置入了一根单腔输液导管用于药物输注。置管操作在超声引导下进行，确认导丝位于静脉管腔内。X线片显示穿刺导引器已穿透无名静脉。通过单腔输液导管注入造影剂，显示置入了左乳内静脉。本文讨论了门静脉高压与中心静脉置管误置风险增加之间的关联，以及该罕见并发症的诊断和潜在预防方法。
