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June 1973

Cardiac TamponadeA Fatal Complication of Central Venous Catheterization

Author Affiliations

From the departments of surgery, medicine, and pathology, the Johns Hopkins Medical Institutions, Baltimore.

Arch Surg. 1973;106(6):868-870. doi:10.1001/archsurg.1973.01350180100029

A case of acute pericardial tamponade occurred secondary to a central venous catheter; and 11 similar cases are reviewed from the literature. The tamponade in these cases is thought to be secondary to perforation of an intrapericardial structure by the central venous catheter. In 11 of the 12 patients a venous cutdown was performed using a long beveled polyethylene catheter. The correct diagnosis was made in only five instances prior to the patient's death, and in only a single case was pericardiocentesis performed early allowing for the patient's survival. Careful placement of the catheter tip outside of the heart, and the use of pliable nonbeveled silicone elastomer (Silastic) catheters are suggested as means of preventing this lethal complication of central venous catheterization.