title: Horner's syndrome in patients admitted to the intensive care unit that have undergone central venous catheterization: a prospective study.
abstract: PurposeCentral venous catheterization (CVC) is estimated to be performed in millions of patients per year. Swan-Ganz catheters used for CVC are most often inserted into the internal jugular vein and during this procedure they may come into contact with the sympathetic chain. This study aims to determine the incidence of Horner's syndrome in patients admitted to intensive care unit that have undergone internal jugular CVC insertion during their admission and to determine whether ultrasonography-assisted insertion has decreased the frequency of this complication.Patients and methodsA total of 100 prospective patients admitted to the ICU were examined for the presence of anisocoria and ptosis after undergoing recent CVC. Presence of Horner's syndrome was confirmed by testing with 0.5% apraclonidine and looking for the reversal of anisocoria.ResultsFrequency of Horner's syndrome after CVC was 2% in a sample of 100 prospectively examined patients.ConclusionHorner's syndrome remains a relatively rare but definitive complication of CVC. ICU physicians should be educated about its existence and prevalence and ophthalmologists should inquire about any history of ICU admission necessitating CVC insertion in any patient presenting with Horner's syndrome.
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Z
authors.initials: Z
authors.lastname: Butty
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.|Department of Ophthalmology, University of West Indies, Kingston, Jamaica.
authors.forename: J
authors.initials: J
authors.lastname: Gopwani
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.|Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Margolin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015875:Anisocoria / Q000175:diagnosis; D001763:Blepharoptosis / Q000175:diagnosis; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006732:Horner Syndrome / Q000175:diagnosis / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult