Repeated hemothorax following ipsilateral left internal jugular and left subclavian venous catheterization

Abstract

Central venous catheterization is one of the most commonly used invasive procedures in critically ill patients. The most frequent sites of cannulation are the internal jugular and subclavian veins. They permit hemodynamic monitoring and allow access for the administration of fluids, blood products, medications, and total parenteral nutrition (TPN). Complications include arterial puncture with the internal jugular approach (0.1 to 4%) and pneumothorax or hemothorax with the subclavian approach (1 to 5%). Our patient with left internal juguler vein catheterization was complicated with hemothorax in the first cannulation application in operation. Left subclavian vein was cannulated in the intensive care unit and catheter was placed into the thorax. Overall, internal jugular and subclavian venous catheterization carry similar risks of mechanical complications as multiple cannulation applications in ipsilateral side, might increase complication rate.