Hydrothorax caused by catheter malposition misdiagnosed via using plain radiography

Hydrothorax caused by catheter malposition misdiagnosed via using plain radiography

We report the case of a child with hydrothorax caused by the misidentification of catheter malposition using plain radiography. A 9-month-old girl underwent central venous catheterization via the right subclavian vein. Catheter tip was evaluated mistakenly as in the right atrium by plain radiography. The catheter was retracted 2 cm and 1/3 normal saline infusion was initiated at 15 ml/hr. The patient became hypoxemic at the 20th hour of fluid infusion. On radiography, the right lung was completely opaque and the catheter tip was positioned in the right lung. Bedside sonography revealed a massive pleural effusion in the right lung and the catheter tip in the right pleural space. The catheter was removed and the pleural effusion was drained via chest tube. The location of the catheter tip should be determined by an accurate technique before infusing fluid. Plain radiography can be misleading for the detection of malposition.

___

  • Stroud A, Zalieckas J, Tan C, Tracy S, Zurakowski D, Mooney DP. Simple formulas to determine optimal subclavian central venous catheter tip placement in infants and children. J Pediatr Surg 2014;49(7):1109-12.
  • Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev 2015;9:1.
  • Kunizawa A, Fujioka M, Mink S, Keller E. Central venous catheter-induced delayed hydrothorax via progressive erosion of central venous wall. Minerva Anestesiol 2010;76(10):868-71.
  • Domino KB, Bowdle TA, Posner KL, Spitellie PH, Lee LA, Cheney FW. Injuries and liability related to central vascular catheters: a closed claims analysis. Anesthesiology 2004;100(6):1411-8.
  • Lennon M, Zaw NN, Pöpping DM, Wenk M. Procedural complications of central venous catheter insertion. Minerva Anestesiol 2012;78(11):1234-40.
  • Wen M, Stock K, Heemann U, Aussieker M, Küchle C. Agitated saline bubble-enhanced transthoracic echocardiography: a novel method to visualize the position of central venous catheter. Crit Care Med 2014;42(3):231-3.
  • Kumar M, Singh A, Sidhu KS, Kaur A. Malposition of subclavian venous catheter leading to chest complications. J Clin Diagn Res 2016;10(5):16-8.
  • Jabeen S, Murtaza G, Hanif MZ, Morabito A, Khalil B. Migration of indwelling central venous catheter and fatal hydrothorax. European J Pediatr Surg Rep 2014;2(1):32-4.
  • Badada V, Singh TK, Srivastava U. Accidental placement of central venous catheter in lung parenchyma causing hydrothorax. Saudi J Anaesth 2014;8(1):113-4.
  • R Isguder, Gulfidan G, Agın H, Devrim I, Karaarslan U, Unal N. Central venous catheretization in pediatric intensive care unit: a four-years experience. CAYD 2014;1014(1):31-8.
İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi-Cover
  • ISSN: 1300-1744
  • Yayın Aralığı: 4
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Periodontal health status of children with type 1 diabetes mellitus

Ceren GOKMENOGLU, Mufide DİNCER, Mugem Asli GUREL, Nehir Canıgür BAVBEK

Efficacy of monopolar radiofrequency in middle and lower face laxity

Hilal GÖKALP

Pemphigus vulgaris presenting as bleeding gums: A case report

Shruthi HEGDE, Subhas BABU, Sajad Ahmad BUCH, Shruthi RAO, Vidya AJILA

The level of knowledge of hepatitis B infection among Turkish dental students

Cankat KARA, Ceren GOKMENOGLU, Gokcen ALTUN, Elif SADIK

Review of pathophysiology, epidemiology, diagnosis and treatment methods in motion sickness; a special issue

Tuba BAYİNDİR, Cigdem Firat KOCA

Does platelet indices play a role in the distinction of pulmonary embolism clinical forms?

Dilara KAMAN, Funda Gulcu BULMUS, Gamze KIRKIL, Selda TELO

Ultrasonographic measurement of palatine tonsil size and its correlation with body-mass index and hepatosteatosis in adolescents

Mehmet OZTURK

Hydrothorax caused by catheter malposition misdiagnosed via using plain radiography

Yasemin ALTUNER TORUN, Alper OZCAN, Ayse Betul ERGUL

Comparison of results of minimal invasive surgery for pilonidal sinus with Karydakis procedure: less is more

Osman CİVİL, Cagri TİRYAKİ, Mehmet OZYİLDİZ, Murat Burç YAZICIOĞLU, Adem YUKSEL, Selim Yigit YİLDİZ, Murat COSKUN

Ectodermal dysplasia: a rare entity featuring complete anodontia: Case report and review of literature with a note on genetics

Vathsala NAİK, Raghavendra KİNİ, Jasmine Shanthi KAMATH