PERICARDIAL TAMPONADE FROM CENTRAL VENOUS CATHETERS

Abstract

Central venous pressure monitoring has become a frequently utilized adjunct in management of the critically ill patient. Central venous pressure is usually obtained through a cannula in the right atrium or intrathoracic cava. No technic of cannulation has been entirely free of complications. Recently pericardial tamponade has been added as a potential hazard. This complication can be treated adequately when present and can be prevented if proper technic is utilized. Two cases are presented with pericardial tamponade from cardiac perforation of a central venous cannula, both recognized in the same medical center in a brief period of time. Report of Cases Case1.—A 19-year-old Negro woman was admitted to Vanderbilt University Hospital on Feb 19, 1968 with a small caliber bullet wound of the left hemithorax. At the time of admission a left tube thoracostomy was performed evacuating 500 ml of blood. At the same time a nonradioopaque PE240 36