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CASE REPORT
A rare case of malposition of central venous catheter detected by ultrasonography-guided saline flush test
  1. Niraj Kumar1,
  2. Ashutosh Kaushal1,
  3. Kapil Dev Soni2,
  4. Gaurav Singh Tomar1
  1. 1Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Critical and Intensive Care, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
  1. Correspondence to Dr Niraj Kumar, drnirajaiims{at}gmail.com

Summary

Central venous catheter (CVC) insertion is associated with many potential complications; malposition of the catheter is one of them. A chest X-ray is routinely done to detect the malposition of catheter, but sometimes it has been seen that X-ray is time-consuming and its accuracy is also low for determining the exact position of the catheter tip. In our case, an ultrasonography (USG)-guided CVC was placed into the right internal jugular vein of the patient. As there was no ECG change obtained during insertion of guidewire and catheter, malposition was suspected, which was easily detected by a novel USG-guided saline flush test. We present a case report where USG was used for detection of a misplaced CVC (from right internal jugular vein to right subclavian vein). With ultrasound, the location of the catheter tip can be confirmed in very less time compared with chest X-ray.

  • Adult Intensive Care
  • Neuroanaesthesia
  • Anaesthesia

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Footnotes

  • Contributors NK (corresponding author): Conception and design, acquisition of data, interpretation of data, revising it critically for important intellectual content, drafting the article. AK: Conception and design, acquisition of data. KDS: Interpretation of data. GST: Final approval of the version, revising it critically for important intellectual content.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.