Open AccessFinding on a chest radiograph: A dangerous complication of subclavian vein cannulation
Author(s) -
Nataraj Madagondapalli Srinivasan,
Akshay Kumar
Publication year - 2010
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.4103/0972-5229.68225
Subject(s) - medicine , chest radiograph , subclavian vein , accidental , catheter , subclavian artery , arterial catheter , surgery , radiology , radiography , blood pressure , air embolism , auscultation , complication , physics , acoustics
Cannulation of the subclavian vein has its inherent risks. Post procedure chest radiograph is one of the investigations done to rule out immediate complications. Unless the clinician is aware as to what to look for in the radiograph, some of the dangerous complications can be overlooked. Accidental subclavian artery cannulation is identifi ed immediately by color and jet of the blood. Also the position of the catheter tip has to be confi rmed by obtaining the arterial pressure tracing using a pressure transducer. Non availability of Doppler ultrasound and pressure transducer are limiting factors for immediate confi rmation of proper catheter placement. Also, in patients with severe hypotension and reduced oxygen content of blood, accidental arterial puncture may not show the characteristic bright red pulsatile back fl ow of arterial blood. In these situations radiography can be used as a diagnostic tool to rule out subclavian artery cannulation.