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Transient right phrenic nerve palsy associated with central venous catheterization
1Department of Anesthesia, Uwajima Social Insurance Hospital, Japan.
British Journal of Anaesthesia
|August 23, 2001
Summary
Central venous catheterization can cause phrenic nerve palsy, leading to diaphragm elevation. Adjusting catheter position can resolve this complication, as seen in an elderly colon cancer patient.
Area of Science:
- Medical Case Reports
- Surgical Complications
- Neurology
Background:
- Central venous catheterization is a common procedure for nutritional support in patients with advanced cancers.
- Phrenic nerve palsy is a rare but serious complication that can arise from central venous catheter placement.
Observation:
- An 85-year-old woman with sigmoid colon cancer developed right phrenic nerve palsy after left subclavian central venous catheterization.
- Imaging confirmed proper catheter placement but showed right hemidiaphragmatic elevation, indicative of palsy.
Findings:
- The phrenic nerve palsy resolved completely within three days after repositioning the central venous catheter by 3 cm.
- The likely cause was catheter tip impingement on the superior vena cava wall, compressing the adjacent phrenic nerve.
Implications:
- This case highlights a potential iatrogenic cause of phrenic nerve palsy.
- Awareness and prompt catheter adjustment can manage this complication, preventing further respiratory compromise.