A Case of Unrecognized Intrathoracic Placement of a Subclavian Central Venous Catheter in a Patient with Large Traumatic Hemothorax

Dina Wallin; Alicia R Privette; Andre R Campbell; Julin F Tang

doi:10.1155/2015/382624

A Case of Unrecognized Intrathoracic Placement of a Subclavian Central Venous Catheter in a Patient with Large Traumatic Hemothorax

Case Rep Emerg Med. 2015:2015:382624. doi: 10.1155/2015/382624. Epub 2015 Aug 11.

Authors

Dina Wallin¹, Alicia R Privette², Andre R Campbell³, Julin F Tang⁴

Affiliations

¹ UT Austin Pediatric Emergency Medicine Fellowship, Dell Children's Medical Center, 4900 Mueller Boulevard, Austin, TX 78723, USA.
² Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, USA.
³ Division of General Surgery, San Francisco General Hospital, Campus Box 0807, San Francisco, CA 94143-0807, USA.
⁴ Department of Anesthesia and Critical Care Medicine, San Francisco General Hospital, 1001 Potrero Avenue, SFGH 5, San Francisco, CA 94110, USA.

Abstract

Traditional recommendations suggest placement of a subclavian central venous catheter (CVC) ipsilateral to a known pneumothorax to minimize risk of bilateral pneumothorax. We present the case of a 65-year-old male with a right hemopneumothorax who was found to have intrathoracic placement of his right subclavian CVC at thoracotomy despite successful aspiration of blood and transduction of central venous pressure (CVP). We thus recommend extreme caution with the interpretation of CVC placement by blood aspiration and CVP measurement alone in patients with large volume ipsilateral hemothorax.