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A Carbon Monoxide Poisoning Case in Which Hyperbaric Oxygen Therapy Was Not Possible Due to Iatrogenic Pneumothorax after Unnecessary Central Catheterization

  • Kim, Hyung Il (Department of Emergency Medicine, Dankook University Hospital, College of Medicine, Dankook University) ;
  • Oh, Seong Beom (Department of Emergency Medicine, Dankook University Hospital, College of Medicine, Dankook University)
  • Received : 2019.12.01
  • Accepted : 2019.12.13
  • Published : 2019.12.30

Abstract

Hyperbaric oxygen therapy (HBOT) is used to treat carbon monoxide (CO) poisoning. However, untreated pneumothorax is an absolute contraindication for HBOT. More caution is needed with regard to monoplace hyperbaric chambers, as patient monitoring and life-saving procedures are impossible inside these chambers. Central catheterization is frequently used for various conditions, but unnecessary catheterization must be avoided because of the risk of infection and mechanical complications. Herein, we describe a case of CO poisoning in which iatrogenic pneumothorax developed after unnecessary subclavian central catheterization. The patient did not need to be catheterized, and HBOT could not be performed because of the pneumothorax. Hence, this case reminds us of basic-but nonetheless important-principles of catheterization.

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References

  1. Thom SR. Hyperbaric oxygen in critical care. In: Vincent JL, Abraham EA, Moore FA, Kochanek PM, Fink MP, eds. Textbook of critical care. 6th ed. Philadelphia:Elsevier Saunders; 2011:373-5.
  2. Leach RM, Rees PJ, Wilmshurst P. Hyperbaric oxygen therapy. BMJ 1998;317:1140-3. https://doi.org/10.1136/bmj.317.7166.1140
  3. Korean Statistical Information Service (KOSIS). The payment status of the inpatients according to the diseases [Internet]. Daejeon: KOSIS 2019 [cited 2019 Nov 26]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=350&tblId=DT_35001_A077312&conn_path=I2.
  4. Andrade SM, Santos IC. Hyperbaric oxygen therapy for wound care. Rev Gaucha Enferm 2016;37:e59257.
  5. Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on hyperbaric medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med 2017;47:24-32.
  6. Carlson S, Jones J, Brown M, Hess C. Prevention of hyperbaric-associated middle ear barotrauma. Ann Emerg Med 1992;21:1468-71. https://doi.org/10.1016/S0196-0644(05)80063-0
  7. Christopher R. McNeil SRR, Bruce DA. Central venous catheterization and central venous pressure monitoring. In: Christopher R. McNeil, Salim R. Rezaie, Bruce DA, eds. Roberts and Hedges' clinical procedures in emergency medicine. 6th ed. Philadelphia: Elsevier Saunders; 2014:397-431.
  8. Deshpande KS, Hatem C, Ulrich HL, Currie BP, Aldrich TK, Bryan-Brown CW, et al. The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population. Crit Care Med 2005;33:13-20; discussion 234-5. https://doi.org/10.1097/01.CCM.0000149838.47048.60
  9. Othman H, Rosman H, Saravolatz L, Rama K. Aortic cannulation: an unexpected complication of central venous catheter placement. J Cardiothorac Vasc Anesth 2017;31:e52-3. https://doi.org/10.1053/j.jvca.2017.02.021
  10. Wetzel LR, Patel PR, Pesa NL. Central venous catheter placement in the left internal jugular vein complicated by perforation of the left brachiocephalic vein and massive hemothorax: a case report. A A Case Rep 2017;9:16-9. https://doi.org/10.1213/xaa.0000000000000511
  11. Yang CW, Bae JS, Park TI, Lee JC, Sohn JE, Kang R, et al. Transient right hemidiaphragmatic paralysis following subclavian venous catheterization: possible implications of anatomical variation of the phrenic nerve -a case report-. Korean J Anesthesiol 2013;65:559-61. https://doi.org/10.4097/kjae.2013.65.6.559
  12. Eisen LA, Narasimhan M, Berger JS, Mayo PH, Rosen MJ, Schneider RF. Mechanical complications of central venous catheters. J Intensive Care Med 2006;21:40-6. https://doi.org/10.1177/0885066605280884
  13. Mainland PA, Tam WH, Law B, Ngan Kee W. Stroke following central venous cannulation. Lancet 1997;349:921. https://doi.org/10.1016/S0140-6736(97)24013-4
  14. Pikwer A, Acosta S, Kolbel T, Malina M, Sonesson B, Akeson J. Management of inadvertent arterial catheterisation associated with central venous access procedures. Eur J Vasc Endovasc Surg 2009;38:707-14. https://doi.org/10.1016/j.ejvs.2009.08.009
  15. Marino P. Vascular access. In: Marino P, ed. The ICU book. 4th ed. Philadelphia:Wolters Kluwer;2014:3-15.