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[Cardiac tamponade and central venous catheterization].

Y M Metayer1, J L Gerard, M Pegoix

  • 1Département d'Anesthésie-Réanimation, CHU Côte-de-Nacre, Caen.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1992
PubMed
Summary

A central venous catheter complication led to fatal cardiac arrest in a patient receiving postoperative analgesia. Prevention involves using short catheters and radiological confirmation of tip placement.

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Area of Science:

  • Cardiology
  • Anesthesiology
  • Intensive Care Medicine

Background:

  • A 32-year-old female underwent surgery for a colonic stricture.
  • A right internal jugular central venous catheter was placed for parenteral feeding during general and epidural anesthesia.

Observation:

  • The patient developed sudden chest pain, tachycardia, cyanosis, and ventricular tachycardia, progressing to cardiac arrest.
  • Upon intensive care unit admission, she presented with coma, ventricular tachycardia, left haemopneumothorax, and pneumopericardium.

Findings:

  • Postmortem examination revealed an ulcerated tricuspid valve, right ventricular perforation, and a pericardial-pleural communication.
  • The cause of death was attributed to a rare, life-threatening complication of central venous catheterization.

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Implications:

  • This case highlights the diagnostic and therapeutic challenges of central venous catheter-related complications.
  • Recommendations for prevention include using shorter catheters and radiological verification of catheter tip position.