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Hickman catheter dislodgement due to pendulous breasts
D W Moorman1, M C Horattas, D Wright
1Akron General Medical Center, Northeastern Ohio Universities College of Medicine, OH 44307.
JPEN. Journal of Parenteral and Enteral Nutrition
|September 1, 1987
Summary
Catheter dislodgement, a rare complication, can occur due to positional changes in individuals with large breasts or gynecomastia. Gravitational forces on breast tissue may cause traction, leading to catheter movement and potential dislodgement.
Area of Science:
- Medical Devices
- Surgical Complications
- Patient Anatomy
Background:
- Hickman, Broviac, and Mediport catheters are common long-term venous access devices.
- Catheter dislodgement is a recognized but poorly understood complication.
- Previous literature has not identified specific etiological factors for catheter dislodgement.
Observation:
- Five cases of catheter dislodgement were observed in women with large breasts.
- One case of catheter dislodgement was observed in a man with gynecomastia.
- Positional changes were noted as a common factor in these cases.
Findings:
- Gravitational forces acting on large breast tissue create motion in the subcutaneous layer.
- This motion exerts downward and outward traction on the subcutaneous portion of the catheter.
- This traction mechanism is proposed as the etiology for catheter dislodgement in affected individuals.
Implications:
- Understanding this specific etiology can inform catheter placement techniques.
- Modified placement strategies may help prevent dislodgement in susceptible patients.
- Further research into patient-specific anatomical factors influencing catheter stability is warranted.