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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
Summary
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.
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