Special article: retained guidewires after intraoperative placement of central venous catheters.
Guidewire retention is a rare complication of central venous catheter placement, and has been related to operator fatigue, inexperience, and inattention, and inadequate supervision of trainees. The true incidence of guidewire loss after intraoperative placement of central venous catheters is unknown. We report 4 cases of guidewire loss after central venous access procedures performed by anesthesia providers in the operating room. Worsening of patients' clinical condition during catheter placement and complex procedures necessitating more than one guidewire insertion are recurring scenarios in cases involving guidewire loss. Over 6 years at our institution, intraoperative wire loss occurred at a rate of 1:3291 procedures (95% confidence interval of 1/10,000 to 8/10,000).
Department of Anesthesiology, Washington University in St. Louis, Campus Box 8054, 660 S. Euclid Ave., St. Louis, MO 63110, USA. vannucca@wustl.edu
Andrea
A
Vannucci
Alicia
A
Jeffcoat
Catherine
C
Ifune
Christian
C
Salinas
James R
JR
Duncan
Michael
M
Wall
D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged