Lymphatic leak complicating central venous catheter insertion.
Many of the risks associated with central venous access are well recognized. We report a case of inadvertent lymphatic disruption during the insertion of a tunneled central venous catheter in a patient with raised left and right atrial pressures and severe pulmonary hypertension, which led to significant hemodynamic instability. To our knowledge, this rare complication is previously unreported.
Barnacle
Alex M
AM
Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK. alexbarnacle@yahoo.co.uk
Kleidon
Tricia M
TM
D000293:Adolescent; D000768:Anesthesia, General / Q000379:methods; D001794:Blood Pressure / Q000502:physiology; D009202:Cardiomyopathies / Q000150:complications; D002316:Cardiotonic Agents / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D004298:Dopamine / Q000008:administration & dosage; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000628:therapy*; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008208:Lymphatic System / Q000293:injuries*; D014463:Ultrasonography
D002316:Cardiotonic Agents; D004298:Dopamine