06 December 2016 : Case report
A Missing Guide Wire After Placement of Peripherally Inserted Central Venous Catheter
Diagnostic / therapeutic accidents, Unusual setting of medical care, Clinical situation which can not be reproduced for ethical reasonsMuhammad Kashif1EF*, Hafiz Hashmi1F, Preeti Jadhav2E, Misbahuddin Khaja1EF
Am J Case Rep 2016; 17:925-928
BACKGROUND: Central venous catheterization is a common tool used in critically ill patients to monitor central venous pressure and administer fluids and medications such as vasopressors. Here we present a case of a missing guide wire after placement of peripherally inserted central catheter (PICC), which was incidentally picked up by bedside ultrasound in the intensive care unit.
CASE REPORT: A 50-year-old Hispanic male was admitted to the intensive care unit for alcohol intoxication. He was managed for septic shock and required placement of a peripherally inserted central line in his left upper extremity for antibiotics and vasopressor administration. A bedside ultrasound performed by the intensivist to evaluate upper extremity swelling revealed a foreign body in the left arm. Percutaneous procedure by Interventional radiologist was required for retrieval of the guidewire.
CONCLUSIONS: Guide wire related complications are rarely reported, but are significantly associated with mortality and morbidity. The use of ultrasound guidance placement of PICC lines decreases the risk of complications, provides better optimal vein selection, and enhances success.
Keywords: Catheterization, Central Venous, Foreign Bodies, Radiography, Interventional, Ultrasonography
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