Needle loss in subclavian vein during central venous catheter placement: case report of a rare complication

Patient Safety in Surgery

Joseph Babrowicz¹  Shawn Sarin⁵  Keith Mortman⁴  Duane Stillions²  Annie Mooser³  Daniela Botolin⁶ 

[1] Division of Vascular Surgery, The George Washington University Hospital, Foggy Bottom South Pavilion, 22nd & I Street, NW, 6th Floor, Washington 20037, DC, USA;Department of Anesthesiology and Critical Care Medicine, The George Washington University Hospital, 900 23rd Street, NW, Washington 20037, DC, USA;Division of General Surgery, Walter Reed National Military Medical Center, 8901 Rockville Pike, Arrowhead Building, 1st Floor, Bethesda 20889, MD, USA;Division of Thoracic Surgery, The George Washington University Hospital, Foggy Bottom South Pavilion, 22nd & I Street, NW, 6th Floor, Washington 20037, DC, USA;Department of Radiology, The George Washington University Hospital, 900 23rd Street, NW, Washington 20037, DC, USA;Department of Surgery, The George Washington University Hospital, 2150 Pennsylvania Avenue, NW, Suite 6B, Washington 20037, DC, USA

关键词: Obesity;    Ultrasound;    Fluoroscopy;    Catheter;    Subclavian;   

Others  :  1132065
DOI  :  10.1186/s13037-014-0049-y

 received in 2014-10-30, accepted in 2014-12-16,  发布年份 2015

【 摘 要 】

We present a case of needle separation during central venous catheter (CVC) placement in a super morbidly obese patient with subsequent surgical intervention in its retrieval. This complication, potentially lethal due to the relevant anatomy of such a procedure, alerts critical care physicians and surgeons to the possibility of equipment failure and stresses proper technique in what has become a routine procedure. It also emphasizes the routine use of ultrasound-guidance for cannulation in patients of any body habitus. While infection and arrhythmia are the generally known complications of CVC placement, clinicians must be alert to unanticipated events such as needle separation. In our case, the retrieval of this needle required multi-disciplinary intervention between radiology, critical care, vascular surgery, and thoracic surgery. Our event stresses hypervigilance to complications in a common procedure.

【 授权许可】

   
2015 Botolin et al.; licensee BioMed Central.

【 图 表 】

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