Preventing Central Venous Catheter Misplacement: Lessons from a Catheter Malposition

Authors

  • Arindam Das Joy RMO, General ICU, United Hospital Limited, Bangladesh
  • Amina Sultana Consultant, General ICU & Surgical ICU, United Hospital Limited, Bangladesh
  • Mohammad Omar Faruq Senior Consultant, Critical Care Medicine, Unico Hospitals PLC, Bangladesh

DOI:

https://doi.org/10.3329/bccj.v14i1.88388

Keywords:

Central Venous Catheterization, Catheter Malposition, Complications, Subclavian Vein, Septic Shock, Patient Safety, Ultrasonography, Critical Care Medicine

Abstract

Central venous catheter (CVC) insertion is not only a very crucial procedure in critical care areas but also a very risky one. Performing the procedure under ultrasound guidance has improved safety, however, catheter malposition remains a frequent complication. Malposition bears risks of dysfunction and thrombosis. In this case report, we look into the case of a 26 years old female with recurrent pancreatitis who developed septic shock and required CVC placement. Chest X-ray done after the procedure revealed misplacement of the catheter tip in the ipsilateral subclavian vein rather than the lower third of the superior vena cava (SVC). The catheter was then removed immediately and replaced under ultrasonography (USG) guidance. We are going to delve into the anatomical and technical factors causing such malposition as well as the role of methods like manometry and electrocardiographic (ECG) tip navigation to complement USG for real-time tip confirmation. We close our discussion with saying that a multi-modal approach, pushing beyond the limits of USG-guided catheter placement, is essential to prevent such predicament and its associated morbidity, particularly in unstable patients where landmark techniques may be attempted.

Bangladesh Crit Care J March 2026; 14 (1): 68-70

Downloads

Download data is not yet available.
Abstract
0
PDF
0

Downloads

Published

2026-04-08

How to Cite

Joy, A. D., Sultana, A., & Faruq, M. O. (2026). Preventing Central Venous Catheter Misplacement: Lessons from a Catheter Malposition. Bangladesh Critical Care Journal, 14(1), 68–70. https://doi.org/10.3329/bccj.v14i1.88388

Issue

Vol. 14 No. 1 (2026)

Section

Clinical Image

License

Upon acceptance for publication the copyright of the paper automatically transfers to the BCCJ and will not be published elsewhere either in part or whole without written permission of the copyright holder.

Except for personal use, no part of the materials published in this journal may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, photocopying, recording or otherwise without the prior written permission of the publisher.