Misplacement of central vein catheters in patients with hemothorax: a new approach to resolve the problem.
BACKGROUND
In emergency and pre-hospital care, the verification of the correct position of a central venous catheter is based on the observation of blood color reflow as well as pressure changes with respiration. However, in trauma patient with hemothorax, these indices may not always be reliable signs as the catheter is in a blood-filled pleural space.


METHODS
A review of reports published describing patients presenting hemothorax and equipped with central venous catheter wrongly assumed to be in the correct position was performed.


RESULTS
Over 10 years, seven reports have been published and a last study was found in the references list of one of the reviews.


CONCLUSIONS
In patients with hemothorax due to severe thoracic trauma or other causes, a delay in detection of incorrect placement of a central venous catheter may delay fluid resuscitation and decrease the chances of survival. In this situation, the use of portable ultrasound devices may be an useful method to increase success rate in catheter insertion.
Wiklund
Claes U
CU
Surgical Intensive Care Unit, Department of Anesthesiology, Pharmacology and Surgical Intensive Care, Geneva University Hospitals, Switzerland.
Romand
Jacques-Andre
JA
Suter
Peter M
PM
Bendjelid
Karim
K
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D006491:Hemothorax / Q000000981:diagnostic imaging*; D006801:Humans; D019300:Medical Errors; D014463:Ultrasonography