Extract:
“A right internal jugular central venous catheter (CVC) placed under ultrasound guidance in the intensive care unit was complicated by a lost guidewire during skin dilation. Pertinent VA ECMO settings included: pump speed of 3,600 rotations per minute, blood flow rate of 3.9 L/min, and venous circuit pressure of –71 mm Hg. Immediate neck ultrasound, chest, abdominal, and pelvic X-ray (Figure 1A-C) failed to reveal the guidewire. It was found hours later in the VA ECMO access cannula tubing (Figure 1D) close to the pump (Figure 1E, Supplementary Video 1), confirming our suspicion of an entrained guidewire within the circuit. Nil changes in venous access cannulae parameters were noted. It was successfully removed later with a circuit change.”
Reference:Devanand NA, Dohnt S, Farquharson M. Transjugular central venous catheter guidewire embolism to venoarterial extracorporeal membrane oxygenation cannula. Acute Crit Care. 2023 Dec 26. doi: 10.4266/acc.2023.01270. Epub ahead of print. PMID: 38148037.