Document Detail

Arterial misplacement of a femoral central venous catheter complicated with acute arterial occlusion.
MedLine Citation:
PMID:  15813248     Owner:  NLM     Status:  MEDLINE    
Femoral vein catheterization is often carried out during resuscitation and in critical care units. It is usually achieved via a blind, external landmark-guided technique, through manual localization of the femoral artery. However, this approach can be challenging in patients with severe shock because of absence or ambiguity of the arterial pulse. We report a case of inadvertent cannulation, with a large-bore catheter, of the right femoral artery, which was mistaken as a venous route for medication and massive transfusion. The large cannula caused direct mechanical obstruction, while intra-arterial medications induced vascular injury and vasospasm. Both factors led to thrombosis and occlusion of the right external iliac artery, thus jeopardizing the distal blood supply, and ultimately resulting in muscle necrosis of the involved limb, and the need for thrombectomy and extensive fasciotomy to salvage the extremity. This case highlights that correct placement of a central venous catheter should be clearly ascertained before the catheter is used for medical treatment, especially when catheterization is performed in shock status.
Hung-Lung Hung; Kuo-Yung Chao; Li-Ming Tseng; Fang-Ming Hung; Tak-Yu Lee
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of the Chinese Medical Association : JCMA     Volume:  68     ISSN:  1726-4901     ISO Abbreviation:  J Chin Med Assoc     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-04-07     Completed Date:  2005-04-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101174817     Medline TA:  J Chin Med Assoc     Country:  China (Republic: 1949- )    
Other Details:
Languages:  eng     Pagination:  138-41     Citation Subset:  IM    
Department of Anesthesiology, Far-Eastern Memorial Hospital, Panchiao, Taipei, R.O.C.
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MeSH Terms
Arterial Occlusive Diseases / etiology*,  surgery
Catheterization, Central Venous / adverse effects*
Femoral Artery*
Femoral Vein
Iliac Artery*
Middle Aged
Thrombosis / etiology*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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