Abstract:
Central venous catheterization is a very common technique, although its complications can be multiple and sometimes fatal. A case is presented of cardiac tamponade by parenteral nutrition a few hours after moving a central venous catheter peripherally inserted a few days before. The diagnosis was made by echocardiography, and an emergency pericardiocentesis was performed, achieving complete recovery of the patient. Peripherally inserted central venous catheters are more likely to change their position secondary to the movements of the patient’s arm, thus it is important to use soft catheters, make sure the tip lies above the carina to avoid perforation of the pericardial reflexion, and fix it well to the skin. Diagnosis must be made as soon as possible, given the high mortality rate of this complication, and the essential diagnostic tool is echocardiography. Elective treatment consists of early catheter withdrawal and emergency pericardiocentesis.
Reference:
García-Galiana, E., Sanchis-Gil, V. and Martínez-Navarrete, M.A. (2014) Cardiac tamponade after withdrawal of a peripheral access central catheter. Revista Española de Anestesiología y Reanimación. June 11th. (Epub ahead of print). (Article in Spanish).