title: Subclavian venipuncture following ipsilateral extrapleural dissection is hazardous.
abstract: Subclavian artery puncture is an infrequent complication of subclavian vein cannulation. In spite of the limited ability to apply direct pressure to the bleeding vessel, significant hematoma or exsanguinating bleeding rarely occurs. This study was a retrospective chart review of a neonate who underwent extrapleural repair of a tracheo-esophageal fistula and sustained significant blood loss following an accidental ipsilateral subclavian artery puncture. This case highlights the importance of an intact apical pleura in controlling bleeding from the subclavian vessels. Thus, ipsilateral percutaneous subclavian venipuncture should be avoided in patients in whom the apical pleura is not intact.
authors.affiliation: Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030-2399, USA.
authors.forename: Bindi
authors.initials: B
authors.lastname: Naik-Mathuria
authors.forename: Oluwaferanmi O
authors.initials: OO
authors.lastname: Okanlami
authors.forename: Olutoyin A
authors.initials: OA
authors.lastname: Olutoye
authors.forename: Imelda
authors.initials: I
authors.lastname: Tjia
authors.forename: Oluyinka O
authors.initials: OO
authors.lastname: Olutoye
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018962:Phlebotomy / Q000009:adverse effects*; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000293:injuries*; D013908:Thoracotomy / Q000379:methods*; D014138:Tracheoesophageal Fistula / Q000601:surgery*