Anesth Pain Med.  2017 Apr;12(2):151-154. 10.17085/apm.2017.12.2.151.

Tension hydrothorax induced by malposition of central venous catheter: A case report

• Ki S
• Kim MH
• Lee W
• Cho H

• KMID: 2379736
• DOI: http://doi.org/10.17085/apm.2017.12.2.151

Abstract

Central venous catheterization is a useful method for monitoring central venous pressure and maintaining volume status. However, it is associated with several complications, such as pneumothorax, hydrothorax, hemothorax, and air embolism. Here we describe a case of iatrogenic tension hydrothorax after rapid infusion of fluid into the pleural space, following the misplacement of an internal jugular vein catheter. Despite ultrasonographic guidance during insertion of the central venous catheter, we were not able to avoid malposition of the catheter. The patient went into hemodynamic compromise during surgery, necessitating chest tube drainage and a mechanical ventilator postoperatively. This case shows that central venous catheter insertion under ultrasonographic guidance does not guarantee proper positioning of the catheter.

Keyword

Central venous catheterization; Hydrothorax; Tension

MeSH Terms

Catheterization, Central Venous
Catheters
Central Venous Catheters*
Central Venous Pressure
Chest Tubes
Drainage
Embolism, Air
Hemodynamics
Hemothorax
Humans
Hydrothorax*
Jugular Veins
Methods
Pneumothorax
Ventilators, Mechanical

Figure

• 

  Fig. 1 A normal anteroposterior chest radiograph before internal jugular catheterization (A). Chest X-ray preformed after operation revealing massive right sided pleural effusion with diffuse pulmonary edema (B).

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