ECG recording of central venous catheter misplaced in inferior thyroid artery
| Autor: | Rosemarie Fröber, Wolfram Schummer, M Paxian, U Settmacher, C. Schummer |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
Catheterization Central Venous medicine.medical_specialty medicine.medical_treatment Thyroid Gland Electrocardiography medicine.artery medicine Humans Inferior thyroid artery Internal jugular vein Aged medicine.diagnostic_test business.industry Thyroid Arteries Foreign Bodies Surgery Catheter Anesthesiology and Pain Medicine medicine.anatomical_structure Introducer sheath Radiology Jugular Veins Hepatectomy business Central venous catheter |
| Zdroj: | British Journal of Anaesthesia. 94:296-299 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aei055 |
| Popis: | A 71-year-old male patient with liver metastases secondary to rectal carcinoma was scheduled for hemi-hepatectomy. Two months earlier he had undergone subtotal resection of the thyroid gland. Prior to surgery, a triple-lumen catheter and an introducer sheath were introduced into the right internal jugular vein using a landmark technique. No problems occurred during insertion of the triple-lumen catheter, but resistance was noticed during insertion of the 8.5 FG introducer sheath. After placement of the introducer sheath, intra-arterial misplacement was confirmed using a pressure transducer. The opportunity was taken to record and compare intravascular ECG by the arterial and venous catheters before removal. No difference was noticed in the P-wave patterns; both showed a marked increase. Surgical exploration of the neck, recommended by the vascular surgeon consulted, showed that the carotid artery was not injured. The introducer sheath had completely punctured the right internal jugular vein and entered the inferior thyroid artery. A thrill was felt. The management of this case is discussed, with suggestions for best practice. Intravascular ECG was unhelpful in differentiating between venous and arterial placement of the catheter. |
| Databáze: | OpenAIRE |
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