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Pericardial Tamponade From Central Venous Catheters

Pericardial Tamponade From Central Venous Catheters Abstract Central venous pressure monitoring has become a frequently utilized adjunct in management of the critically ill patient. Central venous pressure is usually obtained through a cannula in the right atrium or intrathoracic cava. No technic of cannulation has been entirely free of complications. Recently pericardial tamponade has been added as a potential hazard. This complication can be treated adequately when present and can be prevented if proper technic is utilized. Two cases are presented with pericardial tamponade from cardiac perforation of a central venous cannula, both recognized in the same medical center in a brief period of time. Report of Cases Case 1.—A 19-year-old Negro woman was admitted to Vanderbilt University Hospital on Feb 19, 1968 with a small caliber bullet wound of the left hemithorax. At the time of admission a left tube thoracostomy was performed evacuating 500 ml of blood. At the same time a nonradioopaque PE240 36 References 1. Smith, B.E., et al: Complications of Subclavian Vein Catheterization , Arch Surg 90:228-229 ( (Feb) ) 1965.Crossref 2. Bansmer, G.; Deith, D.; and Tesluk, H.: Complications Following Use of Indwelling Catheters of Inferior Vena Cava , JAMA 167:1606-1611 ( (Aug 2) ) 1958.Crossref 3. Longerbeam, J.K., et al: Central Venous Pressure Monitoring: A Useful Guide to Fluid Therapy During Shock and Other Forms of Cardiovascular Stress , Amer J Surg 11:220-230 ( (Aug) ) 1965.Crossref 4. Weil, M.H., and Shubin, H.: Diagnosis and Treatment of Shock , Baltimore: The Williams & Wilkins Co., 1967, pp 274-279. 5. Friedman, B.A., and Jurgeleit, H.C.: Perforation of Atrium by Polyethylene CV Catheter , JAMA 203:1141-1142 ( (March 25) ) 1968.Crossref 6. Phibbs, B.: Central Venous Pressure Monitoring; Localization of a Catheter With Teflon Wire , New Eng J Med 274:270 ( (Feb 3) ) 1966.Crossref 7. McHenry, M.M., and Hopkins, D.M.: Cardiac Tamponade as a Result of Infusion: A Complication of Transvenous Pacing , JAMA 203:167-168 ( (March 18) ) 1968.Crossref 8. Gorlin, R.: Perforations and Other Cardiac Complications , Circulation 37 (suppl 3):36-38 ( (May) ) 1968.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Pericardial Tamponade From Central Venous Catheters

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Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1969.01340080109023
Publisher site
See Article on Publisher Site

Abstract

Abstract Central venous pressure monitoring has become a frequently utilized adjunct in management of the critically ill patient. Central venous pressure is usually obtained through a cannula in the right atrium or intrathoracic cava. No technic of cannulation has been entirely free of complications. Recently pericardial tamponade has been added as a potential hazard. This complication can be treated adequately when present and can be prevented if proper technic is utilized. Two cases are presented with pericardial tamponade from cardiac perforation of a central venous cannula, both recognized in the same medical center in a brief period of time. Report of Cases Case 1.—A 19-year-old Negro woman was admitted to Vanderbilt University Hospital on Feb 19, 1968 with a small caliber bullet wound of the left hemithorax. At the time of admission a left tube thoracostomy was performed evacuating 500 ml of blood. At the same time a nonradioopaque PE240 36 References 1. Smith, B.E., et al: Complications of Subclavian Vein Catheterization , Arch Surg 90:228-229 ( (Feb) ) 1965.Crossref 2. Bansmer, G.; Deith, D.; and Tesluk, H.: Complications Following Use of Indwelling Catheters of Inferior Vena Cava , JAMA 167:1606-1611 ( (Aug 2) ) 1958.Crossref 3. Longerbeam, J.K., et al: Central Venous Pressure Monitoring: A Useful Guide to Fluid Therapy During Shock and Other Forms of Cardiovascular Stress , Amer J Surg 11:220-230 ( (Aug) ) 1965.Crossref 4. Weil, M.H., and Shubin, H.: Diagnosis and Treatment of Shock , Baltimore: The Williams & Wilkins Co., 1967, pp 274-279. 5. Friedman, B.A., and Jurgeleit, H.C.: Perforation of Atrium by Polyethylene CV Catheter , JAMA 203:1141-1142 ( (March 25) ) 1968.Crossref 6. Phibbs, B.: Central Venous Pressure Monitoring; Localization of a Catheter With Teflon Wire , New Eng J Med 274:270 ( (Feb 3) ) 1966.Crossref 7. McHenry, M.M., and Hopkins, D.M.: Cardiac Tamponade as a Result of Infusion: A Complication of Transvenous Pacing , JAMA 203:167-168 ( (March 18) ) 1968.Crossref 8. Gorlin, R.: Perforations and Other Cardiac Complications , Circulation 37 (suppl 3):36-38 ( (May) ) 1968.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Feb 1, 1969

References