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Intertwining and knotting of a guidewire with a central venous catheter
D Olsfanger1, R Jedeiken, B Fredman
1Department of Anesthesia and Intensive Care, Meir Hospital, Kfar Saba, Israel.
Chest
|August 1, 1993
Insights
A guidewire became knotted with a central venous catheter in a patient with multisystem organ failure. Both devices were successfully removed without complications, ensuring patient safety.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Critical Care Medicine
Background:
- Central venous catheters are essential for managing critically ill patients, often inserted via subclavian veins.
- Guidewires are critical tools for navigating and placing vascular access devices.
Observation:
- A guidewire inserted through the left subclavian vein became intertwined and knotted with a pre-existing central venous catheter placed via the right subclavian vein.
- The patient presented with multisystem organ failure, necessitating complex vascular access management.
Findings:
- The intertwined guidewire and central venous catheter were successfully and safely removed.
- No immediate or long-term harm to the patient was documented following the device removal.
Implications:
- This case highlights the potential for guidewire and catheter entanglement, a rare but serious complication.
- Emphasizes the need for meticulous technique and vigilance during insertion and manipulation of multiple intravascular devices in critically ill patients.
- Suggests that careful management and prompt intervention can lead to favorable outcomes even in complex scenarios.
Abstract:
A guidewire, inserted into a 65-year-old patient with multisystem organ failure through the left subclavian vein, intertwined and knotted with an existing central venous catheter previously inserted via the right subclavian vein. Both the guidewire and catheter were removed without any harm to the patient.