Numerous potential complications may occur during the placement of a central venous catheter (CVC). Procedural complications: Arrhythmias – due to guidewire irritation of the atria or ventricles; ventricular or bundle branch blocks may occur. Arterial puncture, pneumothorax, hemothorax, tracheal injury, or air embolism during venous puncture or catheter removal. Guidewire migration if not properly secured, potentially into the right ventricle or inferior vena cava. Key precautions: Ensure proper patient positioning and follow strict sterile procedures.
Keep all necessary personnel and equipment readily available. Always confirm catheter placement with portable chest X-ray (to rule out pneumothorax and confirm tip location in the SVC). Avoid bilateral attempts at subclavian puncture to prevent bilateral pneumothoraces. Never use force during the procedure to prevent local damage.…