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KMID : 0356919940270121833
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Korean Journal of Anesthesiology
1994 Volume.27 No. 12 p.1833 ~ p.1841
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Mediastinal and Bilateral Pleural Effusions due to Extravascular Migration of the Subclavian Catheter during Fluid Therapy
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김용철
김용민/전창호/조문성/김수영/이윤근/김태환/정성량
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Abstract
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Among the various complications of central venous catheterization, extravascular migration of the catheter during fluid therapy is a rare condition to be encountered.
We experienced a case in which an uneventful, successful insertion of subclavian catheter was followed at greater than 33 hours by massive mediastinal and bilateral pleural effusions, which resulted in hypotension, severe dyspnea, and cyanosis.
The
symptoms were relieved immediately after the bilateral thoracostomy and removal of the subclavian catheter. The chemical assay of the effusion was revealed glucose-rich fluid given exogenously. The inferred cause was that postoperative
extravascular
migration of the subclavian catheter probably resulted from both intensive respiratory physiotherapy and movement.
We conclude that, although the successful placement of central line may be confirmed on insertion, a continuous reexamination of both function and location of the line is necessary to avoid the hazards of delayed diagnosis.
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