Delayed vascular injury and severe respiratory distress as a rare complication of a central venous catheter and total parenteral nutrition

被引：5

作者：

Inaba, Kazuki ^{[1
]}

Sakurai, Yoichi ^{[1
]}

Furuta, Shinpei ^{[1
]}

Sunagawa, Risaburo ^{[1
]}

Isogaki, Jun ^{[1
]}

Komori, Yoshiyuki ^{[1
]}

Uyama, Ichiro ^{[1
]}

机构：

[1] Fujita Hlth Univ, Dept Surg, Sch Med, Aichi, Japan

来源：

NUTRITION | 2009年 / 25卷 / 04期

关键词：

Vascular injury; Central venous catheter; Total parenteral nutrition; Pleural effusion; EROSIONS;

D O I：

10.1016/j.nut.2008.10.021

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Complications related to central venous catheters (CVCs) in the postoperative period can be fatal. We recently had a case of bilateral pleural effusion and respiratory distress caused by delayed vascular injury. A 79-y-old Japanese woman was admitted to our hospital because of advanced gastric carcinoma, A multiple-lumen CVC was placed through the left subclavian vein 1 d before surgery for postoperative nutritional management. The patient suddenly complained of dyspnea, and the chest X-ray film revealed right massive pleural effusion. Although the patient's symptoms soon disappeared after the thoracentesis, she again developed severe respiratory distress, and an endotracheal intubation was performed and her respiration was managed by mechanical ventilation. Computed tomographic scan of the chest revealed a displacement of the tip of the CVC out of the wall of the superior vena cava, mediastinitis, and leakage of intravenous fluid, which may have been caused by delayed vascular injury due to the CVC. The CVC was removed immediately after the diagnosis of delayed vascular injury at 10 d after surgery. The patient soon recovered with conservative treatment and was discharged from the hospital 43 d after surgery, This case highlights an extremely rare presenting complication of CVC placement and total parenteral nutrition. (C) 2009 Published by Elsevier Inc.

引用

页码：479 / 481

页数：3