Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry
Central venous catheterization is of common practice in intensive care units; despite representing an essential device in various clinical circumstances, it represents a source of complications, sometimes even fatal, related to its management. We report the removal of a central venous catheter (CVC...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2013/403243 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849406329256411136 |
|---|---|
| author | Meggiolaro Marco Erik Roman-Pognuz Baritussio Anna Scatto Alessio |
| author_facet | Meggiolaro Marco Erik Roman-Pognuz Baritussio Anna Scatto Alessio |
| author_sort | Meggiolaro Marco |
| collection | DOAJ |
| description | Central venous catheterization is of common practice in intensive care units; despite representing an essential device in various clinical circumstances, it represents a source of complications, sometimes even fatal, related to its management.
We report the removal of a central venous catheter (CVC) that had been wrongly positioned through left internal jugular vein. The vein presented complete thrombosis at vascular ultrasonography. An echocardiogram performed 24 hours after CVC removal showed the presence, apparently unjustified, of microbubbles in right chambers of the heart. A neck-thorax CT scan showed the presence of air bubbles within the left internal jugular vein, left innominate vein, and left subclavian vein. A vascular ultrasonography, focused on venous catheter insertion site, disclosed the presence of a vein-to-dermis fistula, as portal of air entry. Only after air occlusive dressing, we documented echographic disappearance of air bubbles within the right cardiac cavity. This report emphasizes possible air entry even many hours after CVC removal, making it mandatory to perform 24–72-hour air occlusive dressing or, when inadequate, to perform a purse string. |
| format | Article |
| id | doaj-art-4ad2e53db543429cb0c6998567d09a88 |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-4ad2e53db543429cb0c6998567d09a882025-08-20T03:36:26ZengWileyCase Reports in Critical Care2090-64202090-64392013-01-01201310.1155/2013/403243403243Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air EntryMeggiolaro Marco0Erik Roman-Pognuz1Baritussio Anna2Scatto Alessio3Division of Anaesthesiology and Intensive Care, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, ItalyDivision of Anaesthesiology and Intensive Care, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, ItalyDivision of Cardiology, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, ItalyDivision of Anaesthesiology and Intensive Care, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, ItalyCentral venous catheterization is of common practice in intensive care units; despite representing an essential device in various clinical circumstances, it represents a source of complications, sometimes even fatal, related to its management. We report the removal of a central venous catheter (CVC) that had been wrongly positioned through left internal jugular vein. The vein presented complete thrombosis at vascular ultrasonography. An echocardiogram performed 24 hours after CVC removal showed the presence, apparently unjustified, of microbubbles in right chambers of the heart. A neck-thorax CT scan showed the presence of air bubbles within the left internal jugular vein, left innominate vein, and left subclavian vein. A vascular ultrasonography, focused on venous catheter insertion site, disclosed the presence of a vein-to-dermis fistula, as portal of air entry. Only after air occlusive dressing, we documented echographic disappearance of air bubbles within the right cardiac cavity. This report emphasizes possible air entry even many hours after CVC removal, making it mandatory to perform 24–72-hour air occlusive dressing or, when inadequate, to perform a purse string.http://dx.doi.org/10.1155/2013/403243 |
| spellingShingle | Meggiolaro Marco Erik Roman-Pognuz Baritussio Anna Scatto Alessio Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry Case Reports in Critical Care |
| title | Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry |
| title_full | Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry |
| title_fullStr | Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry |
| title_full_unstemmed | Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry |
| title_short | Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry |
| title_sort | air embolism after central venous catheter removal fibrin sheath as the portal of persistent air entry |
| url | http://dx.doi.org/10.1155/2013/403243 |
| work_keys_str_mv | AT meggiolaromarco airembolismaftercentralvenouscatheterremovalfibrinsheathastheportalofpersistentairentry AT erikromanpognuz airembolismaftercentralvenouscatheterremovalfibrinsheathastheportalofpersistentairentry AT baritussioanna airembolismaftercentralvenouscatheterremovalfibrinsheathastheportalofpersistentairentry AT scattoalessio airembolismaftercentralvenouscatheterremovalfibrinsheathastheportalofpersistentairentry |