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PICC tip dislodgement causing massive pleural effusion and atelectasis with acute respiratory failure: a case report

Yao Zhu1, Yao Qin2, Juan Felipe Alvarez3

  • 1Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Donghu Rd, Wuchang District, Wuhan, Hubei Province, 430071, China.

BMC Pediatrics
|July 10, 2024
PubMed

Insights

A rare complication of pediatric peripherally inserted central catheter (PICC) placement, catheter malposition, led to respiratory failure in an infant. Point-of-care ultrasound (POCUS) aided in diagnosing and managing this critical event, highlighting the need for vigilance.

Area of Science:

  • Pediatric critical care medicine
  • Medical device safety
  • Diagnostic imaging

Background:

  • Peripherally inserted central catheters (PICCs) are widely used for pediatric intravenous therapy.
  • While generally safe, PICCs can lead to complications such as infection, occlusion, phlebitis, and bleeding.
  • Prompt and accurate diagnosis is crucial for managing PICC-related adverse events in infants.

Observation:

  • A 5-month-old infant experienced respiratory failure due to a malpositioned PICC.
  • Massive fluid infusion into the thoracic cavity was identified as the cause.
  • Point-of-care ultrasound (POCUS) revealed a large pleural effusion requiring urgent drainage.

Findings:

  • Catheter malposition is a rare but severe complication of PICC insertion in pediatric patients.
  • POCUS is an effective tool for the rapid diagnosis of PICC-related complications like pleural effusions.
  • Timely intervention based on POCUS findings can prevent life-threatening outcomes.

Implications:

  • Vigilance in monitoring PICC placement and potential complications is essential for pediatric clinicians.
  • The integration of POCUS can significantly enhance the safety and management of invasive procedures in infants.
  • Further research into standardized protocols for POCUS use in PICC management is warranted.

Keywords:
Case reportPICCPleural effusionUltrasound

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