CVC catheter problems: Difference between revisions

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===Background===
==Background==
[[Central venous catheter]] complications vary by site. Subclavian lines are more commonly associated with pneumothorax and have a higher risk of bleeding because the site is noncompressible, whereas femoral and internal jugular lines have a higher risk of infection.<ref>Parienti JJ, Mongardon N, Mégarbane B, et al. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med. 2015;373(13):1220–1229. doi:10.1056/NEJMoa1500964</ref>
[[Central venous catheter]] complications vary by site. Subclavian lines are more commonly associated with pneumothorax and have a higher risk of bleeding because the site is noncompressible, whereas femoral and internal jugular lines have a higher risk of infection.<ref>Parienti JJ, Mongardon N, Mégarbane B, et al. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med. 2015;373(13):1220–1229. doi:10.1056/NEJMoa1500964</ref>


===Complications===
==Complications==
* Pneumothorax (more common with subclavian)
===Mechanical===
* Arterial puncture (more common with femoral)
*Arterial puncture
* Catheter malposition
*Hematoma formation
* Subcutaneous hematoma
*[[Air embolus]]
* Hemothorax
*[[Pneumothorax]]/Hemothorax
* Catheter related infection (historically more with femoral)
*[[Pericardial tamponade]]
* Catheter induced thrombosis
*Catheter embolus
* Arrhythmia (usually from guidewire insertion)
*[[Dysrhythmias]]
* Venous air embolism (avoid with Trendelenburg position)
*Catheter malposition
* Bleeding


===External Links===
===Infectious===
*[[Bacteremia]]
*[[Sepsis]]
*[[Cellulitis]] at insertion site
 
===Thrombotic===
*[[Pulmonary embolism]]
*[[Venous thrombosis]]
 
===Site-Specific===
 
*SV and IJ
**[[Pneumothorax]]
**[[Hemothorax]]
**[[Hydrothorax]]
**[[Chylothorax]]
**Neck hematoma/tracheal obstruction
**Endotracheal cuff perforation
**Tracheal perforation
**Phrenic nerve injury
**Brachial plexus injury
**Cerebral infarct
 
*Femoral
**Bowel perforation
**[[Psoas abscess]]
**Bladder perforation
 
==External Links==
* [https://pubmed.ncbi.nlm.nih.gov/26398070-intravascular-complications-of-central-venous-catheterization-by-insertion-site/ 3SITES Trial]
* [https://pubmed.ncbi.nlm.nih.gov/26398070-intravascular-complications-of-central-venous-catheterization-by-insertion-site/ 3SITES Trial]
* [https://emcrit.org/emcrit/central-line-micro-skills-deliberate-practice/ EMCrit: CVC Microskills ]
* [https://emcrit.org/emcrit/central-line-micro-skills-deliberate-practice/ EMCrit: CVC Microskills ]


===References===
==References==
<references/>
<references/>


[[Category:Procedures]]
[[Category:Procedures]]

Latest revision as of 14:33, 18 March 2020

Background

Central venous catheter complications vary by site. Subclavian lines are more commonly associated with pneumothorax and have a higher risk of bleeding because the site is noncompressible, whereas femoral and internal jugular lines have a higher risk of infection.[1]

Complications

Mechanical

Infectious

Thrombotic

Site-Specific

External Links

References

  1. ↑ Parienti JJ, Mongardon N, Mégarbane B, et al. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med. 2015;373(13):1220–1229. doi:10.1056/NEJMoa1500964
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