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May 6, 1974

Endotracheal Cuff Perforation Complicating Subclavian Venipuncture

JAMA. 1974;228(6):693. doi:10.1001/jama.1974.03230310015003

To the Editor.—  Percutaneous infraclavicular subclavian catheterization is a relatively benign and simple procedure. Nevertheless, the potential for complications is attested by their frequency (0.4% to 9.9%) and multiplicity. Borja's review enumerates 19 different complications.1 Several authors2,3 have been unable to show a relationship between the frequency of complications and the level of the training of the performer.Here is a previously undescribed complication of infraclavicular subclavian catheterization.

Report of a Case.—  A 46-year-old woman was hospitalized in shock following a motor vehicle accident in which she sustained multiple rib fractures, flail chest, hemopneumothorax, pulmonary contusions, and fracture of the left humerus. Four days later, the patient having progressive dyspnea, bilateral hemopneumothorax, opacification of the left lung, alveolar changes in the right lung, and deteriorating ventilation and oxygenation, a right chest tube was placed, and a nonfunctional left tube corrected. Both were now functional and placed on continuous