[Venous thrombosis secondary to catheter insertion for hypothermia after cardiac arrest. Report of one case].
To improve survival and reduce neurological injury, the use of mild hypothermia following cardiac arrest has been recommended. We report a 65 years old woman who presented an out-of-hospital ventricular fibrillation and cardiac arrest. The patient was comatose following initial resuscitation and was admitted into the ICU, where cooling was initiated using an intravascular catheter. After 48 hours, rewarming was initiated. Although no neurological impairment was observed, physical examination of the right inguinal area and echo-Doppler examination revealed an extensive catheter-related thrombophlebitis with right ileocaval vein occlusion., with high risk of massive and life threatening pulmonary embolism. We report a clinical case and review the literature to point out the need for a high index of diagnostic suspicion of deep venous thrombosis in these specific setting.
Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile. jaimeretamal@gmail.com
Jaime
J
Retamal
Jean
J
Bachler
Ricardo
R
Mejía
Orlando
O
Concha
Max
M
Andresen
D000368:Aged; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D014693:Ventricular Fibrillation / Q000628:therapy