Affordable Access

Access to the full text

Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter

Authors
  • Choi, Hoon1
  • Jeon, Joon Pyo1
  • Huh, Jaewon1
  • Kim, Youme1
  • Hwang, Wonjung1
  • 1 The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea , Seoul (South Korea)
Type
Published Article
Journal
BMC Anesthesiology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jun 01, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12871-021-01254-4
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundPulmonary artery catheter insertion is a routine practice in high-risk patients undergoing cardiac surgery. However, pulmonary artery catheter insertion is associated with numerous complications that can be devastating to the patient. Incorrect placement is an overlooked complication with few case reports to date.Case presentationAn 18-year-old male patient underwent elective mitral valve replacement due to severe mitral valve regurgitation. The patient had a history of synovial sarcoma, and Hickman catheter had been inserted in the right internal jugular vein for systemic chemotherapy. We made multiple attempts to position the pulmonary artery catheter in the correct position but failed. A chest radiography revealed that the pulmonary artery catheter was bent and pointed in the cephalad direction. Removal of the pulmonary artery catheter was successful, and the patient was discharged 10 days after the surgery without complications.ConclusionsTo prevent misplacement of the PAC, clinicians should be aware of multiple risk factors in difficult PAC placement, and be prepared to utilize adjunctive methods, such as TEE and fluoroscopy.

Report this publication

Statistics

Seen <100 times