title: Airway obstruction due to a pre-vertebral haematoma following difficult central line insertion--implications for ultrasound guidance and review of the literature.
abstract: We describe a case of airway obstruction secondary to a large pre-vertebral cervico-mediastinal haematoma following failed attempts at insertion of an internal jugular central venous line. The need for a high index of suspicion to diagnose this injury and early aggressive intervention to manage it are outlined. The role of ultrasound guidance in preventing such a complication is reviewed, as well as other possible mechanisms of haematoma development.
authors.affiliation: Department of Intensive Care Medicine, Royal Brisbane and Womens Hospital, Brisbane, Queensland, Australia
authors.forename: A
authors.initials: A
authors.lastname: Udy
authors.forename: S
authors.initials: S
authors.lastname: Senthuran
authors.forename: J
authors.initials: J
authors.lastname: Lipman
mesh_terms: D000402:Airway Obstruction / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006406:Hematoma / Q000150:complications*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008477:Mediastinal Diseases / Q000150:complications*; D008875:Middle Aged; D010995:Pleural Diseases / Q000150:complications*; D014463:Ultrasonography / Q000379:methods*