Abstract
We present the case of a patient, 60 years old, which has been carrying multiple central venous catheters for hemodialysis. We recived consultation: the patient need a central vascular access. He has malfunctioning of femoral dialysis catheter, central catheter in left internal jugular vein removed a week ago, the right jugulosubclavian territory with thrombosis. We try cannulation of left internal jugular vein, with ultrasound and radiologic guidance. During the procedure, the patient experienced sudden and intense chest pain, which disappear spontaneously in a few seconds. At the end of the procedure one of the catheter´s lights was malfunctioning. Before starting hemodialysis the chest pain is reproduced by serum injection. Rx appropriate check. Chest CT is performed and it shown the vascular perforation. The patient suffer mediastinic perforation due to catheter of 14'5F, into the left brachiocephalic vein. The vascular perforation is in the same area of permcath kink previous.
Highlights
The test characteristics of thoracic Point of Care Ultrasonography (PoCUS) for the diagnosis of acute congestive heart failure (CHF) are not well known, and no prior study evaluated the diagnostic impact of pleural effusions
That might be atribbuted to variable interpretation of ultrasound anatomy – what are we really measuring? Objective: We performed a proof of concept study to evaluate the accuracy of measurments of the optic nerve sheath diameter (ONSD) for contrast enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI)
Good correlation of measurment values was found between CEUS and MRI (ICC 0.98, 95% collapsibility index (CI), 0.74 – 0.99), MRI being regarded as a gold standard
Summary
Measurement of the Inferior Vena Cava (IVC) diameters and collapsibility index (CI) for the detection of early volume depletion in healthy donors was recently investigated by Resnick et al who showed no significant changes using different approaches after blood loss. Objective: To investigate the usefulness of IVC diameters and CI measurement to detect early volume depletion after blood loss of 400450 ml using different sonographic windows. The mid hepatic long-axis window showed the best correlation between the IVC-CI and early volume variations following blood loss and post-donation volume repletion. The 8% remaining was in different areas of the upper limb Cite abstracts in this supplement using the relevant abstract number, e.g.: Ruiz Chacon et al.: Ecography guided puncture vs traditional puncture lancing: benefits for patients at risk in number of attempts to giving comfortable area.
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