Pneumomediastinum complicated by subclavian central venous catheterization in a severe thoracic trauma patient.
Pneumomediastinum is a rare event in subclavian central venous catheterization. However in severe thoracotraumatized patients, such as with bilateral hemopneumothorax, the catherization may be hazardous and made complex by occurrence pneumomediastinum, even the procedure is rightly carried out. We suggest that in such a risky condition, if it is mandatory, it should be carried out in a more placid condition, such as avoidance of high PEEP ventilation, setting lower tidal volume, or brief interruption of positive ventilation, to reduce the likelihood of unperceivable pneumomediastinum.
Chen
Liang-Chih
LC
Department of Anesthesiology, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, ROC.
Tzao
Chi
C
Liaw
Wen-Jinn
WJ
Horng
Huei-Chi
HC
Cherng
Chen-Hwan
CH
Wong
Chih-Shung
CS
Wu
Ching-Tang
CT
D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology*; D011175:Positive-Pressure Respiration; D013902:Radiography, Thoracic; D013350:Subclavian Vein; D013898:Thoracic Injuries / Q000601:surgery*