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CVC migration and drug extravasation

"Despite initial proper positioning, catheter ports can migrate out of intravascular structures due to postprocedural subcutaneous edema. Intravascular confirmation should be performed regularly for infants with localized or generalized edema" Thimmarayan et al (2023).

"Despite initial proper positioning, catheter ports can migrate out of intravascular structures due to postprocedural subcutaneous edema. Intravascular confirmation should be performed regularly for infants with localized or generalized edema" Thimmarayan et al (2023).

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CVC migration and drug extravasation

Abstract:

We report a case of aseptic cutaneous necrosis from extravasation of calcium chloride at the proximal port of a central venous catheter (CVC). A right internal jugular CVC was placed with ultrasound guidance using contemporary guidelines for size and insertion site. Catheter migration occurred concurrent with development of postoperative anasarca. Four days later, leakage of infusate with skin necrosis was noted at the insertion site. Despite initial proper positioning, catheter ports can migrate out of intravascular structures due to postprocedural subcutaneous edema. Intravascular confirmation should be performed regularly for infants with localized or generalized edema.


Reference:

Thimmarayan G, Schmitz M, Guerrero J, Garcia X, Zhang S, Chau D. A neonate with aseptic cutaneous necrosis related to the migration of the proximal central venous catheter infusion port. Paediatr Anaesth. 2023 Sep 20. doi: 10.1111/pan.14767. Epub ahead of print. PMID: 37728186.

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