title: When one port does not return blood: two case reports of rare causes for misplaced central venous catheters.
abstract: We present two cases of misplaced central venous catheters having in common the absence of free blood return from one lumen immediately after placement. The former is a case of right hydrothorax associated with central venous catheterization with the catheter tip in intra-pleural location. In this case the distal port was never patent. In the latter case there was an increased aspiration pressure through the middle port due to a catheter looping. The absence of free flow on aspiration from one lumen of a central catheter should not be undervalued. In these circumstances the catheter should not be used and needs to be removed.
authors.affiliation: Department of Anesthesiology, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal. Electronic address: sandra.mgpereira@hotmail.com.
authors.forename: Sandra
authors.initials: S
authors.lastname: Pereira
authors.affiliation: Department of Anesthesiology, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.
authors.forename: César
authors.initials: C
authors.lastname: Preto
authors.affiliation: Department of Anesthesiology, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Pinho
authors.affiliation: Department of Anesthesiology, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Vasconcelos
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006876:Hydrothorax / Q000000981:diagnostic imaging / Q000209:etiology*
keywords: Alça; Cateter venoso central; Central venous catheter; Hidrotórax; Hydrothorax; Looping; Malposition; Mau posicionamento