Brachial Plexopathy: Complication of Subclavian Vein Catheterization

Abstract

ABSTRACT Central venous catheters (CVCs) are often used in critical care setting for resuscitation and monitoring and as a temporary access for hemodialysis. The increased risk of complications associated with CVCs chronic kidney disease (CKD) patients is not recognized widely. Neurological complications are extremely rare with only few cases reported. Brachial plexus injury may occur by direct needle injury or by compressive effects of a hematoma. Prompt evacuation of hematoma is warranted to prevent permanent neurological sequelae. We describe a case of brachial plexopathy after subclavian vein cannulation attempt with full recovery on conservative treatment. Prevention of such complications is the best way to reduce morbidity in CKD patients. For this timely creation of an arteriovenous fistula in CKD patients, ultrasound-guided insertion of CVCs, use of internal jugular vein as the preferred route, and close watch on coagulation defects due to uremic state is recommended. Key messages Chronic kidney disease (CKD) patients should have a permanent vascular access (arteriovenous fistula) well in advance of anticipated time of initiation of dialysis. How to cite this article Beniwal P, Malhotra V, Mathur M. Brachial Plexopathy: Complication of Subclavian Vein Catheterization. Panam J Trauma Crit Care Emerg Surg 2014;3(2):76-78.