Skip to main content
SpringerLink
Log in

Pericardial tamponade caused by central venous catheters

  • Original Scientific Reports
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Three cases of pericardial tamponade caused by central venous catheters are reported. Two essential factors have been recognized. First, the catheter material should be extremely soft and remain soft. Today the best material available seems to be a silicone rubber elastomer. Polyvinylchloride or polyethylene, which is widely used, is too rigid. These materials also contain phthalate esters to soften the plastic, and these softeners are gradually washed out into the bloodstream, rendering the catheters even more rigid in time. Second, a central venous catheter should enter the venous system proximal to the shoulder. When the catheter is inserted through a vein in the arm, the tip of the catheter will be able to progress 6–10 cm farther down in the venous system by extreme movements of the arm. This occurs regularly when a patient is turned in bed and his or her arm is elevated 108‡ at the shoulder. The internal jugular vein and the subclavian vein are the most suitable veins for catheterization. Veins in the arm should not be used.

Résumé

Trois cas de “tamponade” péricardique après cathétérisme veineux central sont rapportés cependant que deux causes particulières de ce type d'accident iatrogène ont été mises en évidence:-emploi d'un catheter rigide.-lieu inadéquat d'introduction de cet élément. En fait, le catheter doit Être souple et le rester, le meilleur matériaux étant représenté par le silicone. Le catheter en polyethylene largement employé est trop rigide, il contient également des éléments chimiques qui ont pour but de l'assouplir mais qui sont éliminés progressivement dans le sang.

D'autre part le catheter doit Être introduit dans le système veineux a proximité de l'épaule. Quand il est mis en place au niveau du bras il peut progresser de 6 à 10 cm dans le système veineux sous l'impulsion des mouvements du membre supérieur. Ceci survient régulièrement quand le malade est retourné dans son lit et que le membre est ainsi levé à 180‡. La veine jugulaire interne ou la veine sous clavière représentent le meilleur lieu d'introduction du cath éter. Il ne faut jamais le mettre en place au niveau d'une veine brachiale.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Greenall, M.J., Blewitt, R.W., McMahon, M.J.: Cardiac tamponade and central venous catheters. Br. Med. J.2:595, 1975

    Google Scholar 

  2. Iglesias, A., Maronas, J.M., Rufilanchas, J.J., Figuera, D.: Perforation of the right ventricle and cardiac tamponade caused by a venous catheter. Postgrad. Med. J.53:225, 1977

    Google Scholar 

  3. Migliori, G., Michelangeli, F., Codinach, F., Blaive, B.: Perforations cardiaques par catheter veineux central. Nouv. Presse Méd.5:987, 1976

    Google Scholar 

  4. Thomas, C.S., Jr., Carter, J.W., Lowder, S.C.: Pericardial tamponade from central venous catheters. Arch. Surg.98:217, 1969

    Google Scholar 

  5. Brandt, R.L., Foley, W.J., Fink, G.H., Regan, W.J.: Mechanism of perforation of the heart with production of hydropericardium by a venous catheter and its prevention. Am. J. Surg.119:311, 1970

    Google Scholar 

  6. Göthman, B., Wallensten, S., Wickbom, G.: Tre fall av mekaniska komplikationer jÄmte PM för metodik vid intravenös infusion. LÄkartidningen68:3301, 1971

    Google Scholar 

  7. Brown, C.A., Kent, A.: Perforation of right ventricle by polyethylene catheter. South. Med. J.49:466, 1956

    Google Scholar 

  8. Johnson, C.E.: Perforation of right atrium by a polyethylene catheter. J.A.M.A.195:176, 1966

    Google Scholar 

  9. Barton, J.J., Vanecko, R., Gross, M.: Perforation of right atrium and resultant cardiac tamponade: A complication of catheterization to measure central venous pressure. Obstet. Gynecol.32:556, 1968

    Google Scholar 

  10. Kline, I.K., Hofman, W.I.: Cardiac tamponade from CVP catheter perforation. J.A.M.A.206:1794, 1968

    Google Scholar 

  11. Defalque, R.J.: Fatal complication of subclavian catheter. Can. Anaesth. Soc. J.18:681, 1971

    Google Scholar 

  12. Adar, R., Mozes, M.: Fatal complications of central venous catheters. Br. Med. J.3:746, 1971

    Google Scholar 

  13. Henzel, J.H., De Weese, M.S.: Morbid and mortal complications associated with prolonged central venous cannulation. Am. J. Surg.121:600, 1971

    Google Scholar 

  14. Colvin, M.M., Savege, T.M., Blogg, C.E., Jarvis, J.D., Strunin, L.: A safe long-term infusion technique? Lancet2:317, 1972

    Google Scholar 

  15. Bethel, H.J.N.: Long-term intravenous infusions. Lancet2:433, 1972

    Google Scholar 

  16. Bell, J.A., Bradley, R.D., Jenkins, B.S.: Malpositioning of central venous catheters. Lancet1:105, 1973

    Google Scholar 

  17. Solassol, C., Joyeux, H.: Nouvelles techniques pour nutrition parentérale chronique. Arq. Gastroent. S. Paulo12:41, 1975

    Google Scholar 

  18. Normand, M., Joyeux, H., Cayotte, J.-L., Chouraqui, D.: Cathétérisme de la veine jugulaire interne pour nutrition parentérale. Nouv. Presse Méd.46:4225, 1978

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Regional County Hospital, örebro, Sweden

    M. Krog M.D., L. Berggren M.D., M. Brodin M.D. & G. Wickbom M.D.

Authors
  1. M. Krog M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Berggren M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Brodin M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Wickbom M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krog, M., Berggren, L., Brodin, M. et al. Pericardial tamponade caused by central venous catheters. World J. Surg. 6, 138–142 (1982). https://doi.org/10.1007/BF01656389

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01656389

Keywords

Search

Navigation