[Mediastinal infusion by a multilumen central venous catheter]

Area of Science:

• Vascular Access
• Medical Device Complications
• Radiology

Background:

• Internal jugular vein (IJV) catheterization is a common procedure.
• Shaldon catheters, with multiple side-holes, are frequently used for central venous access.
• Complications can arise from improper catheter placement.

Observation:

• A case involving a Shaldon catheter inserted via the left IJV is presented.
• The patient developed progressive pulmonary edema and peripheral vasoconstriction.
• Clinical assessment suggested the catheter was functioning adequately.

Findings:

• Radiographic imaging with radiopaque dye revealed mediastinal penetration by the catheter tip.
• The most distal side-hole was within the mediastinum, while proximal holes remained intravascular.
• This malpositioning explained the patient's cardiorespiratory symptoms.

Implications:

• Confirms the risk of mediastinal malpositioning with IJV catheters.
• Highlights the diagnostic value of contrast-enhanced radiography for suspected catheter-related issues.
• Recommends routine radiographic confirmation in patients with unexplained cardiorespiratory distress after catheterization.