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Updated: May 20, 2025

Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model
Published on: March 31, 2023
Hemothorax Complicating Hickman Line Placement in a Pediatric Patient: A Case Report of Early Recognition and
Feras Ayaz1, Osamah Arafah1, Khalid Aljonaieh1
1Anesthesia, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.
Insights
Central venous catheters (CVCs) are vital for pediatric bone marrow transplants. A rare complication, hemothorax, occurred during Hickman line placement in an infant, requiring immediate intervention for survival.
Area of Science:
- Pediatric critical care medicine
- Vascular access procedures
- Hematology and oncology
Background:
- Central venous catheters (CVCs) are critical for long-term venous access in pediatric patients, especially for bone marrow transplantation (BMT).
- While CVC insertion is common, it carries inherent risks, including vascular injury and hemorrhage.
Abstract:
Central venous catheters (CVCs) are essential in managing pediatric patients requiring long-term venous access, particularly for bone marrow transplantation (BMT). Although generally safe, their insertion is not without risks. We report the case of a one-year-old boy with Severe Combined Immunodeficiency Disorder (SCID) who developed a life-threatening right-sided hemothorax during Hickman line placement. The patient presented with acute hemodynamic instability and pulseless electrical activity (PEA) following multiple failed cannulation attempts. Immediate resuscitation measures restored circulation, and imaging revealed a large hemothorax. A chest tube was inserted, draining 138 mL of blood, leading to clinical stabilization. This case highlights the importance of early complication recognition, imaging, and prompt intervention during central venous catheterization.
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