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Related Experiment Videos

Paediatric cardiac arrest during Hickman line insertion

S P Bass1, A E Young

  • 1Great Ormond Street Hospital for Children, NHS Trust, London, UK.

Paediatric Anaesthesia
|January 1, 1997
PubMed
Summary

A child experienced cardiac arrest due to a misplaced central venous catheter (CVC) in a persistent left superior vena cava (LSVC). Prompt diagnosis via echocardiography led to a full recovery, highlighting CVC placement risks.

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Area of Science:

  • Cardiology
  • Pediatric Anesthesiology
  • Medical Imaging

Background:

  • Central venous catheters (CVCs) are crucial for administering medications and monitoring in pediatric patients.
  • An errant placement of a CVC can lead to serious complications, including cardiac events.
  • Persistent left superior vena cava (LSVC) is a rare congenital anomaly where the left superior vena cava drains into the coronary sinus.

Observation:

  • A four-year-old girl suffered cardiac arrest during anesthesia due to complete heart block.
  • The event occurred during the flushing of a long-term central venous catheter.
  • The catheter was found to be incorrectly placed within a persistent left superior vena cava (LSVC) draining into the coronary sinus.

Findings:

  • The misplacement of the CVC into the LSVC directly connected to the coronary sinus was the cause of the cardiac arrest.
  • Diagnosis was initially suspected via chest X-ray.
  • Two-dimensional echocardiography confirmed the LSVC and the catheter's aberrant position.

Implications:

  • This case underscores the critical importance of verifying central venous catheter placement, especially in pediatric patients with potential congenital anomalies.
  • Awareness of LSVC and its potential complications during CVC insertion is vital for anesthesiologists and interventional cardiologists.
  • Accurate and timely diagnosis using imaging modalities like echocardiography is essential for managing such critical events and ensuring patient recovery.

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