Inadvertent transpericardial insertion of a central venous line with cardiac tamponade failure of preventive practices

Abstract

A 56-year-old man who had undergone cardiac surgery suffered from cardiac tamponade after administration of contrast-medium through a central venous catheter. Pericardiotomy showed the catheter transversing the pericardial sac just beneath an unusual high reflection and then reentering the superior vena cava. Preventive practices including chest radiography, confirming free venous blood return and manometry may fail to detect catheter malposition in rare cases. Knowledge of potential pitfalls in using generally recommended safety practices and continuous vigilance are essential for the anesthesiologist and intensivist in avoiding potentially lethal hazards.

DOI: 10.1007/s001340051331

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@article{Losert2000InadvertentTI, title={Inadvertent transpericardial insertion of a central venous line with cardiac tamponade failure of preventive practices}, author={Heidrun Losert and Rupert W. Prokesch and Martin Grabenwoeger and Barbara Waltl and Robert Apsner and Gere Sunder-Plassmann and Manfred Muhm}, journal={Intensive Care Medicine}, year={2000}, volume={26}, pages={1147-1150} }