Entrapment of a subclavian venous catheter in a child—How to get it out?

Abstract

To report a rare case of an entrapped subclavian venous catheter and to describe an anatomically based maneuver to remove it. Case report. Pediatric critical care unit in a tertiary care hospital. An 8-yr-old girl suffering from 50% body surface area burns and clinical sepsis in whom a double lumen subclavian venous catheter, placed 12 days earlier, could not be removed. Concomitant abduction and internal rotation of the shoulder and outward traction in the scapular plane plus backward pressure on the first rib while carefully pulling out the entrapped catheter. Successful removal of the intact catheter, avoiding catheter disruption and embolization. Side hole of an acutely placed multilumen catheter may be entrapped at the costoclavicular angle. An anatomically-based maneuver may widen the gap between the clavicle and the first rib and enable safe removal of the catheter.