An Accidental Arterial Puncture and Anticoagulation after Internal Jugular Vein Catheterization Resulting in Massive Hematoma and Airway Compromise

Ruetzler Kurt,Hatem Alkadhi,Spahn Donat R,Piegeler Tobias,Hauffe Till

doi:10.23937/2377-4630/1410069

Abstract

An Accidental Arterial Puncture and Anticoagulation after Internal Jugular Vein Catheterization Resulting in Massive Hematoma and Airway Compromise

Highlights

Central venous catheterization (CVC) is widely used in clinical practice for diverse purposes, including invasive hemodynamic monitoring, radiological studies, infusion of drugs that cannot be administered via peripheral venous access, administration of parenteral nutrition, vascular access in patients whose peripheral veins are difficult to catheterize, and procedures that require access to large-caliber vessels [1]
Pneumothorax, hematothorax, arterial puncture, hematoma, nerve lesions, damage to the left thoracic duct, and air embolism are among the main mechanical complications
There is compelling evidence that ultrasound-guided CVC insertion via the internal jugular veins is associated with higher success rates and fewer mechanical complications compared with the traditional techniques based on external anatomical landmarks

Summary

Introduction

Central venous catheterization (CVC) is widely used in clinical practice for diverse purposes, including invasive hemodynamic monitoring, radiological studies, infusion of drugs that cannot be administered via peripheral venous access, administration of parenteral nutrition, vascular access in patients whose peripheral veins are difficult to catheterize, and procedures that require access to large-caliber vessels [1]. We report a clinical case of 76-years-old female patient requiring urgent placement of a central venous catheter and unrecognized arterial puncture and subsequent heparin overdose with nearly fatal outcome. The traditional CVC insertion technique relies on the use of anatomical landmarks rather than ultrasound guidance.

Results

Conclusion