• Journal of Chest Surgery
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• v.41 no.4
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• pp.504-507
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• 2008

Implantable central venous catheters (Chemoport) are increasingly being used for vascular access, parenteral nutrition and administering chemotherapeutic agents. As with most invasive procedures, central venous catheterization is associated with numerous potential complications such as infection, thoromboembolism and occlusion. A rare but serous complication is the catheter fracture. We present here three cases of catheter fracture as a consequence of Pinch off syndrome, and we include a review of the relevant literature.

• Clinical and Experimental Pediatrics
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• v.49 no.2
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• pp.157-161
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• 2006

Purpose : The purpose of this study is to investigate the pathogens of central venous catheter-related blood stream infections and search for the association among the insertion site, the duration and the underlying conditions with the prevalence of central venous catheter-related blood stream infections under 15 years old. Methods : A retrospective study was performed from Jan, 2003 to Dec, 2003 in Severance Hospital on 112 patients who undertook central venous catheter insertions. Results : We examined 112 patients who undertook central venous catheter insertion. The mean age of patients was $4.77{\pm}4.12$ years old. Coagulase negative Staphylococci was the most common organism of central venous catheter-related blood stream infections accounting for 33.9 percent, followed by Eenterococcus faecium(9.3 percent), and Staphylococcus aureus(7.5 percent), The most common insertion site was the right femoral vein, followed by the right jugular vein and the left femoral vein. The mean insertion period was $14.17{\pm}12.00$ days. Conclusion : Central venous catheter-related blood stream infections were not only related to the underlying conditions, but also to the insertion site. We need to study the clinical importance of coagulase negative Staphylococci as it is part of the normal flora of the skin. In future, more studies are needed to take preventive measures and improve treatment methods.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1120-1125
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• 2002

Purpose : Percutaneous cannulation of the central vein in children and infants may be technically difficult and can cause serious complications. There are many techniques to improve the success rate and to decrease the complications in central vein cannulation. This study was undertaken to determine whether audible Doppler guidance can help operators improve the results of central vein cannultion in pediatric ICU. Methods : A total of 46 central vein cannulations were performed using audible Doppler guidance technique. Using an 8-MHz Doppler ultrasound device(Pocket-Dop II. iMex. USA), the artery and the vein were identified by their characteristic Doppler sounds. Results : There was a total of 46 patients with 20 boys and 26 girls, respectively. The mean age was $3years{\pm}45months$(range : 1-156 months). The number of infants was 18 and the mean age was $6.3{\pm}3.8$ months(range : 1-12 months). The most common site of central vein cannulation was the right internal jugular vein(63%). The cannulation was successful in 44 out of 46 procedures(96%). The success rate at the first attempt was 59% with 48% in the patients who had the history of previous cannulation and 70% in the patients who did not, respectively. The success rate in infants was 94%(17 out of 18). The average access time was $5.2{\pm}8.3$ minutes in children contrary to $7.5{\pm}10.3$ minutes in infants. There were no serious complications, but six patients had complications including four hematoma, one arterial puncture, and one pneumothorax. Conclusion : This central vein cannulation using Doppler guidance may improve the success rate of central vein cannulation and decrease the development of serious complications in infants and children.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.691-695
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• 2007

Background: The introduction of central venous catheters in 1979 has aided the administration of chemotherapy to oncologic patients. We analyzed the clinical reviews and complications of totally implantable venous catheters in an effort to achieve optimal management. Material and Method: We retrospectively studied 100 cases with totally implantable venous catheter at our hospital and we report the results. Result: 100 totally implantable venous catheters were placed in the right subclavian vein in 74 cases (74%), the left subclavian vein in 21 cases, the right jugular vein in 3 cases, the left jugular vein in 1 case and the right femoral vein in 1 case. The immediate complications were 5 cases in malposition of the catheter and 5 cases of arterial puncture. The late complications were 1 case of subclavian vein thrombosis, which was treated with anticoagulation, and 2 cases of pinch-of syndrome. There were no other early or late complications. Conclusion: The low rate of complications in this study confirms the safety and convenience of using totally implantable venous catheter in patients undergoing prolonged chemotherapy. Yet because Infection, thrombosis, and catheter fracture are the most common long term complications of totally implantable venous catheters, early diagnosis and management of these problems can prevent severe complications.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.902-905
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• 2006

We report a case in which routine chest roentgenograms of an 840 g infant led to the belief that the peripherally inserted central catheter (PICC) was appropriately positioned within the superior vena cava when, in actuality, it was within the azygous arch. Although many cases of pleural effusions have been reported to be caused by a central venous catheter, a right-sided hydrothorax caused by azygous vein rupture from the use of a PICC is an extremely rare complication. Sudden changes in the condition of a preterm infant with PICC should raise the suspicion of a catheter-related problem.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.619-623
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• 1998

A 51-year-old male with chronic renal failure had marked swelling and tenderness of the right arm. Venography revealed central vein occlusion involving stenosis of right proximal subclavian vein, right internal jugular vein, and left distal innominate vein, and obstruction of right brachiocephalic vein. Multiple obstruction of these veins was thought to have resulted from repeated subclavian catheterization. Right subclavian-superior vena cava was bypassed with 10 mm Gore-tex vascular graft and then left subclavian vein with 8 mm Gore-tex vascular graft was bypassed to the 10 mm Gore-tex vascular graft. The results were excellent.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.884-887
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• 2004

We applied our technique of selective bronchial suctioning (SBS) for the treatment of atelectasis after resection surgery of lung in four patients with refractory atelectasis who were treated successfully. We considered that SBS using hydro-catheter insertion under local anesthesia above fourth tracheal ring is the effective technique for the treatment of refractory atelectasis when conventional respiratory therapy is not effective and a bronchoscopist is not available.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.953-959
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• 2005

Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1459-1465
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• 2020

The perforation of the intrathoracic internal jugular vein during the placement of an implantable central venous chemoport is a rare complication that is manifested by hemothorax or hemorrhagic shock. Furthermore, inappropriate instillation of a chemotherapeutic agent in the chemoport can cause chemical pleuritis, and the diagnosis of these complications prior to the instillation of chemotherapeutic agents and open thoracic surgery is mandatory. We report a patient with chemical pleuritis and hemothorax following an inappropriate instillation of a chemotherapeutic agent, through the perforated right internal jugular vein after placement of an implantable central venous chemoport. Treatment by embolization using coils and N-butyl cyanoacrylate, after percutaneous drainage, was successful.

• Journal of Yeungnam Medical Science
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• v.25 no.2
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• pp.175-181
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• 2008

Central venous catheterization via an internal jugular vein or subclavian vein has become a common procedure in monitoring CVP and managing severely ill patients. However, there have beennumerous reports of complications associated with central venous catheterization. These include vessel injury, pneumothorax, hemothorax, nerve injury, arrhythmias, arteriovenous thrombosis, pulmonary embolism, and infection at the insertion site. We report a case of hemothorax after subclavian vein catheterization failure, along with successful treatment.