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KMID : 0378020080510110011
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New Medical Journal
2008 Volume.51 No. 11 p.11 ~ p.15
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Late Appearance of Pneumothorax Complicating Central Venous Catheterization and Positive Ventilation in Central Venous Catheterization and Positive Ventilation in
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Kim Tae-Kwan
Kim Yee-Suk
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Abstract
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Subclavian catheterization is a reliable and popular technique of central venous access for a variety of indication. However, as with most invasive maneuvers, complications can occur and sometimes are potentially fatal if unrecognized pleural leak may pose a hazard, especially in patients undergoing operation under general anesthesia and when positive ventilation pressure is used. We present our experience, an unrecognized small visceral pleural laceration occurred at the time of catheterization which was not large enough to cause a detectable pneumothorax on the initial chest film. However with time, slow accumulation of air turned into the nearly right total lung collapse of life-threatening pneumothorax under positive ventilation. Therefore it is necessary to take great care not to overlook intraoperative delayed pneumothorax in a patient with subclavian vein catheterization under general anesthesia or mechanical respiratory support.
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KEYWORD
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Central venous catheterization, Pneumothorax, Positive pressure ventilation
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