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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)...

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Autores principales: Marco, Meggiolaro, Roman-Pognuz, Erik, Anna, Baritussio, Alessio, Scatto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010003/
https://www.ncbi.nlm.nih.gov/pubmed/24829822
http://dx.doi.org/10.1155/2013/403243
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author Marco, Meggiolaro
Roman-Pognuz, Erik
Anna, Baritussio
Alessio, Scatto
author_facet Marco, Meggiolaro
Roman-Pognuz, Erik
Anna, Baritussio
Alessio, Scatto
author_sort Marco, Meggiolaro
collection PubMed
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.
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spelling pubmed-40100032014-05-14 Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry Marco, Meggiolaro Roman-Pognuz, Erik Anna, Baritussio Alessio, Scatto Case Rep Crit Care Case Report 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. Hindawi Publishing Corporation 2013 2013-10-07 /pmc/articles/PMC4010003/ /pubmed/24829822 http://dx.doi.org/10.1155/2013/403243 Text en Copyright © 2013 Meggiolaro Marco et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Marco, Meggiolaro
Roman-Pognuz, Erik
Anna, Baritussio
Alessio, Scatto
Air Embolism after Central Venous Catheter Removal: Fibrin Sheath as the Portal of Persistent Air Entry
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
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010003/
https://www.ncbi.nlm.nih.gov/pubmed/24829822
http://dx.doi.org/10.1155/2013/403243
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