Central venous catheter (CVC) insertion is a routine procedure in the management of critically ill patients. We report a clinical case of inadvertent placement of an internal jugular vein CVC into the right pleural cavity, despite employing clinical and imaging-based techniques to ensure proper catheter positioning. Infusion of fluids and vasopressors through this misplaced catheter led to hypertensive pleural effusion and subsequent cardiorespiratory arrest. Return of spontaneous circulation was achieved after two cycles of cardiopulmonary resuscitation. While multiple imaging modalities are recommended for confirming appropriate CVC placement, each method has inherent limitations. This case highlights the imperative need for a high index of suspicion to avert such complications and pretends to review some of each method's limitations.
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http://dx.doi.org/10.7759/cureus.61579 | DOI Listing |
Otolaryngol Pol
January 2025
Department of Pediatric Otolaryngology, Medical University of Warsaw, Poland.
<b>Introduction:</b> Central venous thrombosis (CVT) represents a well-documented complication of acute otitis media (AOM) and acute mastoiditis (AM). Despite widespread antibiotic utilization, which has significantly reduced the incidence of severe AOM/AM complications, recent years have witnessed an increasing frequency of thrombotic complications in pediatric patients, not invariably presenting with classical neurological manifestations.<b>Aim:</b> This study aimed to investigate the potential correlation between COVID-19 infection and increased CVT incidence, while sharing therapeutic experiences, given the absence of standardized treatment protocols for otogenic CVT in pediatric populations.
View Article and Find Full Text PDFWorld J Psychiatry
January 2025
Breast Tumor Surgical Outpatient, Hengyang Central Hospital, Hengyang 421000, Hunan Province, China.
Background: The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia, especially thyroid hormones.
Aim: To study the relationship between triiodothyronine (T3), thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH) and schizophrenia.
Methods: In this study, 100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.
Crit Care Explor
January 2025
Division of Cardiovascular Critical Care Medicine, Department of Cardiology, Boston Children's Hospital, Boston, MA.
Background: Accurate assessment of oxygen delivery relative to oxygen demand is crucial in the care of a critically ill patient. The central venous oxygen saturation (Svo) enables an estimate of cardiac output yet obtaining these clinical data requires invasive procedures and repeated blood sampling. Interpretation remains subjective and vulnerable to error.
View Article and Find Full Text PDFCrit Care Explor
January 2025
Department of Infectious Disease, Cleveland Clinic, Cleveland, OH.
Importance: The current definition of central line-associated bloodstream infection (CLABSI) may overestimate the true incidence of CLABSI as it is often unclear whether the bloodstream infection (BSI) is secondary to the central line or due to another infectious source.
Objectives: We aimed to assess the prevalence and outcomes of central CLABSI at our institution, to identify opportunities for improvement, appropriately direct efforts for infection reduction, and identify gaps in the CLABSI definition and its application as a quality measure.
Design Setting And Participants: Retrospective cross-sectional study of patients identified to have a CLABSI in the period 2018-2022 cared for at the value-based purchasing (VBP) units of a 1200-bed tertiary care hospital located in Cleveland, OH.
Cureus
December 2024
Department of Respiratory Medicine, Shin-Yurigaoka General Hospital, Kanagawa, JPN.
Gastrointestinal (GI) metastases from lung cancer are relatively rare, and their management strategies and outcomes in the era of immune checkpoint inhibitors are unknown. A 59-year-old man with lung cancer was hospitalized. He presented with vomiting due to a small intestinal metastasis.
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