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Korean J Anesthesiol > Volume 27(12); 1994 > Article
Korean Journal of Anesthesiology 1994;27(12):1833-1841.
DOI: https://doi.org/10.4097/kjae.1994.27.12.1833   
Mediastinal and Bilateral Pleural Effusions due to Extravascular Migration of the Subclavian Catheter during Fluid Therapy.
Yong Chul Kim, Yong Min Kim, Chang Ho Chun, Moon Seong Cho, Soo Yeong Kim, Yoon Geun Lee, Tae Hwan Kim, Sung Ryang Jung
1Department of Anesthesiology, College of Medicine, Dongguk University, Pohang, Korea.
2Department of Orthopedic Surgery, College of Medicine, Dongguk University, Pohang, Korea.
3Department of Clinical Pathology, College of Medicine, Dongguk University, Pohang, Korea.
Abstract
Among the various complications of central venous catheterization, extravsscular migra tion of the catheter during fluid therapy is a rare condition to be encountered. We experienced a case in which an uneventful, successful insertion of subclavian catheter was followed at greater than 33 hours by massive mediastinal and bilateral pleural effusions, which resulted in hypotension, severe dyspnea, and cyanosis. The symptoms were re- lieved immediately after the bilateral thoracostomy and removal of the subclavian catheter. The chemical assay of the effusion was revealed glucoae-rich fluid given exogenously. The inferred cause was that postoperstive extravascular migration of the subclavian catheter probably resulted from both intensive respiratory physiotherspy and movement. We conclude that, although the successful placement of central line may be confirmed on insertion, a continuous reexamination of both function and location of the line is necessary to avoid the hazards of delayed diagnosis.
Key Words: Subclavian catheter; Extravascular migration; Hydrothorax


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