Delayed vascular injury and severe respiratory distress as a rare complication of a central venous catheter and total parenteral nutrition

Kazuki Inaba, Yoichi Sakurai, Shinpei Furuta, Risaburo Sunagawa, Jun Isogaki, Yoshiyuki Komori, Ichiro Uyama

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Complications related to central venous catheters (CVCs) in the postoperative period can be fatal. We recently had a case of bilateral pleural effusion and respiratory distress caused by delayed vascular injury. A 79-y-old Japanese woman was admitted to our hospital because of advanced gastric carcinoma. A multiple-lumen CVC was placed through the left subclavian vein 1 d before surgery for postoperative nutritional management. The patient suddenly complained of dyspnea, and the chest X-ray film revealed right massive pleural effusion. Although the patient's symptoms soon disappeared after the thoracentesis, she again developed severe respiratory distress, and an endotracheal intubation was performed and her respiration was managed by mechanical ventilation. Computed tomographic scan of the chest revealed a displacement of the tip of the CVC out of the wall of the superior vena cava, mediastinitis, and leakage of intravenous fluid, which may have been caused by delayed vascular injury due to the CVC. The CVC was removed immediately after the diagnosis of delayed vascular injury at 10 d after surgery. The patient soon recovered with conservative treatment and was discharged from the hospital 43 d after surgery. This case highlights an extremely rare presenting complication of CVC placement and total parenteral nutrition.

Original languageEnglish
Pages (from-to)479-481
Number of pages3
JournalNutrition
Volume25
Issue number4
DOIs
Publication statusPublished - 01-04-2009

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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