What is your diagnosis if one central venous catheter port will not aspirate blood

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Abstract:

We present two cases of misplaced central venous catheters having in common the absence of free blood return from one lumen immediately after placement. The former is a case of right hydrothorax associated with central venous catheterization with the catheter tip in intra-pleural location.

In this case the distal port was never patent. In the latter case there was an increased aspiration pressure through the middle port due to a catheter looping. The absence of free flow on aspiration from one lumen of a central catheter should not be undervalued. In these circumstances the catheter should not be used and needs to be removed.

Reference:

Pereira, S., Preto, C., Pinho, C. and Vasconcelos, P. (2016) When one port does not return blood: two case reports of rare causes for misplaced central venous catheters. Brazilian Journal of Anesthesiology. 66(1), p.78-81.

DOI: 10.1016/j.bjane.2014.02.007.

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