title: Case report: anterior mediastinal central line malposition.
abstract: Central venous catheter (CVC) placement is a routine procedure in the management of critically ill patients. It is important to ensure correct positioning of the catheter tip just above the junction of the superior vena cava and the right atrium, to reduce associated complications and to optimize catheter function. The incidence of catheter misplacement is approximately 3%-4% for both subclavian and internal jugular vein access procedures. CVC placement in the right subclavian vein is associated with a higher risk of malposition.(1) We report an unexpected secondary malposition of a right subclavian CVC in the anterior mediastinum, with resultant vena caval perforation in a patient admitted to the neuro-critical care unit after undergoing a craniotomy procedure.
authors.affiliation: University Sapienza Policlinico Umberto I, Via Lodovico Pavoni 86, 00176 Roma, Italy. guidoturi@yahoo.it
authors.forename: Guido
authors.initials: G
authors.lastname: Turi
authors.forename: Paolo
authors.initials: P
authors.lastname: Tordiglione
authors.forename: Fabio
authors.initials: F
authors.lastname: Araimo
mesh_terms: D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D062905:Central Venous Catheters / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging*; D011859:Radiography