Overview of the procedure for removal of central venous catheters

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Intravenous literature: Keegan, M. and Mueller, J.T. (2012) Removal of central venous catheters. Anesthesiology. 117(4), p.917-918.

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Extract:

“The recently published Practice Guidelines for Central Ve- nous Access provide a valuable resource for anesthesiologists and others who insert and maintain central venous catheters (CVCs).1 We commend the members of the American Soci- ety of Anesthesiologists Task Force on their efforts.
Although the guidelines deal extensively with insertion and maintenance of CVCs, there is no discussion of removal of those CVCs. There is considerable anecdotal evidence and a plethora of published case reports highlighting the occur- rence of adverse events during CVC removal, including bleeding and venous air embolism.2,3 Venous air embolism, which occurs as a result of entrainment of air when an open vein is above the level of the heart, has the potential to result in cardiorespiratory compromise, devastating neurologic sequelae, and death.4 –10 A failure to appreciate the potential for, and cause of, venous air embolism may result in im- proper practices during CVC removal. In some circum- stances, inexperience, unfamiliarity, and lack of education or training may play a role.”

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