Department of Anesthesiology and Reanimation, Kolan International Hospital, Istanbul, Turkey. Email:
Department of Anaesthesiology and Reanimation, Yeni Yüzyıl University Medical Faculty, Istanbul, Turkey.
Cardiovasc J Afr. 2023;34(5):321-324. doi: 10.5830/CVJA-2022-062. Epub 2023 Feb 6.
Malposition of a catheter is found in approximately 7% of cases after central venous catheterisation. This may result in haemorrhage, venous thrombosis and functional impairment, depending on the injury to the vessel wall. Uncomplicated catheterisation, easy aspiration of blood and monitoring of catheterisation do not guarantee correct placement of the catheter. In our rare case series, we share our experience of four cases of malposition into the left internal mammary vein (LIMV) that we experienced in a three-year period. The thinness and fragility of the vessel wall, particularly, increases the probability of complications in malposition into the LIMV. Administration of a catheter through the right jugular vein is associated with the lowest incidence of malposition. Performing the procedure under the guidance of ultrasonography (USG) and confirmation of the catheter position after puncture using one of the USG techniques will minimise the probability of malposition. In addition, a lung X-ray should immediately be taken, and venography and fluoroscopy should be considered in the presence of suspicion.
中心静脉置管后约有 7%的病例会出现导管位置不当。这可能会导致出血、静脉血栓形成和功能障碍，具体取决于对血管壁的损伤程度。简单的置管、轻松抽吸血液和监测置管并不能保证导管的正确放置。在我们罕见的病例系列中，我们分享了在三年内遇到的 4 例导管误入左侧内乳静脉（LIMV）的经验。血管壁的薄度和脆弱性特别增加了 LIMV 位置不当的并发症发生的可能性。通过右侧颈静脉置管与最低的导管位置不当发生率相关。在超声引导下（USG）进行操作，并在穿刺后使用其中一种 USG 技术确认导管位置，将最大限度地降低导管位置不当的可能性。此外，应立即拍摄肺部 X 光片，如果怀疑有这种情况，应考虑进行静脉造影和荧光透视。
