Seizures and hemiparesis after subclavian vascular access

doi:N/A

eISSN: None / ISSN: None

Netharland Journal of Critical Care

2014, Volume 18, Issue 3 : 21-23

Article

Seizures and hemiparesis after subclavian vascular access

Scholten J.G.F.

Oostra E.J.

van der Worp H.B.

Spronk P.E.

⁴

de Graaff J.C.

⁵

Department of Anaesthesia, Gelre Hospitals Apeldoorn, Netherlands

Department of Anaesthesia, Isala Clinics Zwolle, Netherlands

Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, Netherlands

⁴

Department of Intensive Care, Gelre Hospitals Apeldoorn, Netherlands

⁵

Department of Anaesthesia, Division of Anaesthesia, Intensive Care and Emergency Medicine, University Medical Centre Utrecht, Utrecht, Netherlands

Abstract

We present a patient with seizures and hemiparesis with long-lasting sequellae following injection of medication and total parenteral nutrition through a centrally placed catheter. The central catheter was inadvertently placed arterially even though no suspicion for incorrect placement had been raised on control chest X-ray. When there is difficult central venous access or doubt about the correct positioning of a catheter, position should be confirmed with chest X-ray in combination with pressure measurement and/or blood gas analysis. At present there is no evidence for specific treatment of neurological symptoms after arterially administered total parenteral nutrition.

Keywords

Cannulation

Central catheter

Complication

Subclavian

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