Highlights the risk of fatal cardiac tamponade from central venous catheter perforation and emphasizes the need for prompt verification of catheter positioning.
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Delayed right ventricular perforation by central venous catheter risks fatal tamponade; leaves open optimal verification timing and techniques.
A fatal case of infusion of a fat emulsion (Intralipid) into the pericardium is reported. Perforation of the anterior wall of the right ventricle of the heart by a central venous catheter had occurred 3 days after insertion via the basilic vein. Local myocardial inflammation and necrosis along the puncture wound through the myocardium was a feature. The incident underlines the necessity for prompt assurance of correct positioning of central venous catheters. It is emphasized that effective treatment is possible if one is aware of some important features of the condition. Immediate diagnosis is mandatory.
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Eide et al. (1983) studied this question.
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