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Related Experiment Videos

Cardiac tamponade from central venous catheters

P E Collier1, S H Blocker, D M Graff

  • 1Department of Surgery, Sewickley Valley Hospital, Pennsylvania, USA.

American Journal of Surgery
|September 16, 1998
PubMed
Summary

Cardiac tamponade from central venous catheters is preventable. Ensuring the catheter tip is outside the cardiac silhouette on chest X-rays can avert this lethal complication. Prompt echocardiograms are crucial for diagnosis.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Patient Safety

Background:

  • Cardiac tamponade (CT) is a potential lethal complication following central venous catheter (CVC) placement.
  • The mechanism of CT and physician awareness of this risk require investigation.

Purpose of the Study:

  • Determine the mechanism of CT after CVC insertion.
  • Assess physician awareness of CT as a CVC complication.

Main Methods:

  • Retrospective review of 25 unreported CT cases associated with CVC.
  • Analysis of chest radiographs and postmortem records.
  • Survey of 200 physicians regarding their knowledge of CT from CVC and FDA educational materials.

Main Results:

  • All reviewed chest radiographs showed CVC tips within the pericardial silhouette.

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  • Patients presented with unexplained hypotension, chest tightness, shortness of breath, or air hunger post-CVC placement.
  • None of the surveyed physicians had viewed the FDA educational video on CVC complications.

    • Conclusions:

    • CT following CVC placement is preventable by ensuring the catheter tip is outside the cardiac silhouette.
    • Patients with CVCs developing unexplained hypotension or cardiorespiratory symptoms require urgent echocardiography to rule out CT.