• Title/Summary/Keyword: Central Venous

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Inadvertent Arterial Catheterization of Central Venous Catheter: A Case Report (중심정맥관의 동맥 내 거치: 증례보고)

  • Oh, Seung-Young
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.292-294
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    • 2015
  • Central venous catheterization is one of the most important procedures for initial resuscitation of hemodynamically unstable patients including multiple trauma patients. Inadvertent arterial placement of the large caliber central venous catheter can results in resuscitation failure as well as unnecessary invasive treatment. Here, we report an arterial puncture during central venous catheterization which may lead to inadvertent arterial catheterization. We recommend that arterial catheterization should be evaluated before dilator insertion during Seldinger's method. Ultrasound can help in preventing the inadvertent arterial catheterization of central venous catheter.

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Effects of Maximal Sterile Barrier Precaution on the Central Venous Catheter-related Infection and Cost (중심정맥관 삽입시 최대멸균 차단법이 중심정맥관 관련 감염률과 비용에 미치는 효과)

  • Lim, Jung-Hye;Kim, Nam-Cho
    • Korean Journal of Adult Nursing
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    • v.22 no.3
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    • pp.229-238
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    • 2010
  • Purpose: The purpose of this study was to examine the effect of maximal sterile barrier precaution on the central venous catheter-related infection and subsequent cost savings. Methods: Study subjects were 462 hospitalized patients with central venous, catheter of more than 48 hours duration. Data collection period was from April 2008 to February 2009 at a tertiary university hospital in Seoul. Subjects were randomly assigned to either the treatment or the usual care group. Patients in the treatment group (n=209) were treated by staff using maximal sterile barrier precautions and the comparison group(n=253) received traditional care. Results: Central venous catheter-days was2,821 in treatment group and 3,515 in comparison group. The incidence density of central venous catheter-related infection was 2.1 times higher in the comparison group (8.2 per 1,000 catheter-days) compared with the treatment group (3.9 per 1,000 catheter-days). The incidence density of central venous catheter-related bloodstream infection was 4.54 times higher than in the comparison group (3.2 per 1,000 catheter-days) compared with the treatment group (0.7 per 1,000 catheter-days). The attributable cost of central venous catheter-related infection in the treatment group was 10,174,197 won and that of the comparison group was 22,224,554 won. Attributable cost by area was also significantly lower compared with that of the comparisons. Conclusion: The maximal sterile barrier precaution during central venous catheter insertion was an effective intervention to reduce central venous catheter-related infection rate and provides a significant cost savings.

Resolved Cerebral Venous Hypertension after Angioplasty of Central Venous Stenosis in a Hemodialysis Patient: A Case Report (혈액투석 환자에서 발생한 중심 정맥 협착의 혈관성형술 후 호전된 대뇌 정맥 고혈압: 증례 보고)

  • Heemin Kang;Sung-Tae Park
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.206-211
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    • 2022
  • Stenosis of the central veins is a common complication in hemodialysis patients. However, cerebral venous hypertension and neurological symptoms caused by central vein stenosis are relatively rare. We present a rare case of cerebral venous hypertension in a 63-year-old male who showed venous reflux into the dural sinuses due to central venous stenosis on time-of-flight MR angiography. After management for central venous stenosis, the venous reflux disappeared.

A Safe Method of Central Venous Catheterization by Peripheral Venous Cutdown in Infants (소아에서 말초정맥을 이용한 중심정맥로 확보법)

  • Han, Seck-Joo;Choi, Seung-Hoon;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.46-52
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    • 1995
  • Percutaneous infraclavicular subclavian catheterization has been widely used for a total parenteral nutrition, hemodynamic monitoring and for venous access in difficult clinical situations. Many authors have claimed the infraclavicular cannulation of the subclavian vein in the tiniest infants can be performed with safety and ease, but there are always possibility of serious complications in this method. We present our experiences of peripheral venous cutdown with Broviac catheter. Author routinely introduced Broviac catheter into central vein via peripheral venous cutdown. There was no life threatening complications and no catheter related death. The complication rate was very low. The catheter related sepsis was documented in only two patient(4.7%). The average catheter longivity was 19.59 days. In view of the safety and low rate of complication, we think that peripheral venous cutdown with Broviac catheter should be the method of choice when central venous access is necessary in infants. The infraclavicular subclavian catheterization should be reserved in infants with few accessible peripheral vein.

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Accidental Vertebral Artery Cannulation as a Complication of the Central Venous Catherization (우발적인 척추동맥으로의 중심정맥 카테터의 삽관)

  • Jeong, Ju Ho
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.33-37
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    • 2014
  • Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

Cranial Vena Cava Syndrome in a Retriever Dog Receiving CPN through Central Venous Catheter

  • Oh, Sangjun;Kang, Jinsu;Kim, Bumseok;Kim, Namsoo;Heo, Suyoung
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.253-257
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    • 2022
  • A 5-year-old castrated male Golden Retriever dog weighing 15 kg presented with evidence of intestinal intussusception. The patient had cachexia and severe dehydration before being referred to our department. Ultrasound imaging revealed a target sign indicative of intestinal intussusception. Emergency surgery was performed shortly after diagnosis. After a successful surgery, the patient was hospitalised for postoperative care. Initial treatment was aimed at the reversion of dehydration and the provision of adequate nutrition. Fluid therapy and central parenteral nutrition were administered via the peripheral and central venous catheters, respectively. Ten days postoperatively, swelling and edema were observed in the head and neck. Ultrasound and computed tomography confirmed complete blockage of the cranial vena cava due to thrombosis, which consequently obstructed both the left and right jugular veins. For treatment, dalteparin and tissue plasminogen activator were administered. However, the patient lost all of its vital function on the daybreak of postoperative day 11. Venous thrombus formation secondary to central parenteral nutrition application via the central line is a rare but possible complication. Veterinarians who are concerned about taking care of patients receiving CPN through the central line should keep the possibility of venous thrombus formation in mind.

Acute Cardiac Tamponade, Report of 6 Cases (각종 원인에 의한 급성 Cardiac Tamponade: 6례 보고)

  • 조장환;이명진;홍승록
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.97-106
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    • 1972
  • We will report 6 cases of cardiac tamponade treated surgically at Severance Hospital during the past 9 years from 1964 to 1972 and reviewed literatures on cardiac tamponade. The age of patients was from 13 years to 45 years old. The male was 4 cases and the female 2 cases. The sites of injury were right atrium; 1 case, right ventricle; 2 cases, right ventricle and coronary artery; 1 case, left atrium; 1 case, and left ventricle; 1 case. 2 cases of cardiac tamponade developed following chest injury, 2 cases following pericardiocentesis,1 case due to continuous bleeding from sutured cardiotomy wound of left atrium following open mitral commissurotomy using cardiopulmonary bypass machine, and 1 case due to traumatic penetration of polyethylene catheter through right ventricle to pericardial sac, introduced via right jugular vein in order to monitor the central venous pressure. Central venous pressure was checked preoperatlvely in 5 cases. In all cases, central venous pressure was rised [the range of central venous pressure was 240 to 330 mmHg]. Immediately after operation,central venous pressure lowered to normal [the range was 80-100 mmHg]. Recently serial gas analysis of arterial blood were checked pre- and post-operatively for the evaluation of hemodynamic change of cardiac tamponade, but our data was not enough for evaluation. It should be studied further.

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Fatal Septic Internal Jugular Vein-Sigmoid Sinus Thrombosis Associated with a Malpositioned Central Venous Catheter

  • Seung, Won-Bae;Kim, Dae-Yong;Kim, Jin-Wook;Park, Yong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.183-186
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    • 2013
  • Septic internal jugular vein-sigmoid sinus thrombosis (IJV-SST) associated with a malpositioned central venous catheter is a rare condition. It is potentially life-threatening and necessitates early diagnosis and rapid administration of appropriate medications. Unfortunately, it is difficult to diagnose due to vague clinical presentations. Several studies such as CT, MRI, and cerebral angiography should be performed and carefully examined to help make the diagnosis. We report a case of septic IJV-SST due to a malpositioned central venous catheter.

Hemothorax after Central Venous Catherization Failure through the Subclavian Vein (쇄골하정맥을 통하여 중심정맥도관 삽입 실패 후 나타난 혈흉 1예)

  • Kim, Dae-Young;Kim, Dae-Woo;Son, Hee-Won;Park, Sang-Jin;Lee, Deok-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.175-181
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    • 2008
  • Central venous catheterization via an internal jugular vein or subclavian vein has become a common procedure in monitoring CVP and managing severely ill patients. However, there have beennumerous reports of complications associated with central venous catheterization. These include vessel injury, pneumothorax, hemothorax, nerve injury, arrhythmias, arteriovenous thrombosis, pulmonary embolism, and infection at the insertion site. We report a case of hemothorax after subclavian vein catheterization failure, along with successful treatment.

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Massive hemothorax after central venous catheter insertion in a patient with multiple trauma

  • Park, Jeong Heon;Song, Jaegyok;Oh, Pyeong-wha
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.1
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    • pp.81-85
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    • 2021
  • Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.