Knotting of a guidewire during internal jugular vein catheterization in an infant: A case report

Area of Science:

• Pediatric critical care medicine
• Vascular access procedures
• Medical device complications

Background:

• Central venous catheterization is a common procedure in pediatric patients.
• Reported complication rates for central venous catheterization range from 3% to 6%.
• Guidewire knotting is a known complication in adults but has not been previously reported in infants.

Purpose of the Study:

• To report the first documented case of guidewire knotting during central venous catheterization in an infant.
• To raise awareness of this potential complication in pediatric patients.
• To suggest clinical considerations for managing suspected guidewire knotting.

Main Methods:

• A case report of an infant undergoing internal jugular vein catheterization.
• Description of the event of guidewire knotting during the procedure.
• Documentation of the successful removal of the knotted guidewire.

Main Results:

• Guidewire knotting occurred during internal jugular vein catheterization in an infant.
• The knotted guidewire was successfully removed without any adverse events.
• No complications were observed in the infant post-procedure.

Conclusions:

• Guidewire knotting is a possible complication during central venous catheterization in infants.
• Clinicians should maintain a high index of suspicion for knot formation if resistance is encountered during catheter advancement.
• Early recognition and intervention are crucial for successful management and prevention of adverse outcomes.