Wednesday, March 19, 2008

Wednesday March 19, 2008

Case: You inserted central line. While you were on your way to check CXR to confirm line placement, nurse request you to check KUB also to confirm enteral feeding tube placement (DHT). Interestingly, KUB shot this morning had IVC filter which is no more present there ?


Answer:
Guide wire during central line procedure probably travelled into inferior vena cava and dislodged IVC filter !!!

Related previous pearls:

Guide wire length

Peres Nomogram




Reference: click to get abstract / article

1. Guidewire Dislodgment of Inferior Vena Cava Filters During Insertion of Central Venous Catheters, Vascular and Endovascular Surgery, Vol. 31, No. 5, 587-593 (1997)

2.
Direct measurement of the distance from subclavian and internal jugular vein access sites to the superior vena cava-atrial junction during central venous catheter placement. Crit Care Med 2000; 28: 138–42

3.
Greenfield Inferior Vena Cava Filter Dislodged During Central Venous Catheter placement, Chest 1994;106;957-959