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The main risks of central venous access devices misplacement include infections, bleeding, perforation of the vessel or organ, and difficulty in removing the device. Misplacement can also lead to catheter-related bloodstream infections and thrombosis, which can result in serious complications such as sepsis and pulmonary embolism. Prompt recognition and correction of misplacement are crucial to reduce these risks and improve patient outcomes.
|Location of catheter tip position||Number of patients||Venous thrombosis||Functional problems|
|SVC cranial 1/3||42||19%||16.7%|
|SVC mid 1/3||142||4.2%||1.4%|
|SVC caudal 1/3||66||1.5%||0%|
|RA or inferior Vena Cava||18||5.5%||5.6%|
Cannulation by the right internal vein n=1023 (63.2%)
Cannulation by the left internal jugular vein n= 104 (6.4%)
Cannulation by the right subclavian vein n=287 (17.7%)
Cannulation by the left subclavian vein n= 37 (2.3%)
|Intravascular Misplacement||Extravascular Misplacement|
|Carotid artery||Extradural space|
|Paersistent left sided superior vena cava||Pleural space|
|Internal thoracic (mammarx) vein||Mediastinum|
|Vertebral vein||Thoracic duct|
Clinical Examination and Treatment
Level of additional length of stay and cost
Complications related to CVAD application
Medica Image to detect misplaced catheter, chest X-ray, alternatively CT or MRI
|+ ∼ +++|
Removal of catheter, according to the sereneness (bedside, via Interventional radiology or via surgery
|+ ∼ ++++|
Catheter removal via Interventional Radiology
Complications related to the misplaced location
Individual surgical or non-surgicak treatment according to the impaired organ or tissue
|++ ∼ ++++|
Drug extravasation into surrounding
Non-surgical or surgical treatment fot extravasation
|++ ∼ ++++|
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