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Lymphatic leak complicating central venous catheter insertion.
Alex M Barnacle1, Tricia M Kleidon
1Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK. alexbarnacle@yahoo.co.uk
Cardiovascular and Interventional Radiology
|May 12, 2005
Summary
A rare complication of central venous catheter insertion, lymphatic disruption, caused severe hemodynamic instability in a patient with pulmonary hypertension. This case highlights a previously unreported risk during tunneled catheter placement.
Area of Science:
- Cardiology
- Vascular Surgery
- Critical Care Medicine
Background:
- Central venous access is a common procedure with known risks.
- Patients with severe pulmonary hypertension often have complex hemodynamic profiles.
- Tunneled central venous catheters are used for long-term access.
Observation:
- A case of inadvertent lymphatic disruption during tunneled central venous catheter insertion is presented.
- The patient had pre-existing raised left and right atrial pressures and severe pulmonary hypertension.
- This complication led to significant hemodynamic instability.
Findings:
- Lymphatic disruption is a rare but serious complication of central venous catheterization.
- The hemodynamic instability was directly linked to the lymphatic injury.
- This specific complication during tunneled catheter insertion appears to be previously unreported in medical literature.
Implications:
- Highlights a novel risk associated with central venous catheter insertion in specific patient populations.
- Emphasizes the importance of careful technique and awareness of potential lymphatic injury.
- Suggests the need for further investigation into the incidence and management of this rare complication.