Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report
A 74-year-old man who had been receiving warfarin for atrial fibrillation, underwent emergency thrombectomy. A central venous catheter (CVC) was inserted via the left subclavian vein, and heparin was administered to prevent preoperative and postoperative thrombotic events. After an uneventful thromb...
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doaj-7f2edfe40cf94da098894297f3684fd82020-11-25T03:43:54ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632014-11-0167535836210.4097/kjae.2014.67.5.3587951Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case reportBoo-Young Hwang0Eunsoo Kim1Won-Sung Kim2Ah-Reum Cho3Mi-Jung Cho4Chung-Won Lee5Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.Department of Cardiovascular and Thoracic Surgery, Pusan National University Hospital, Busan, Korea.A 74-year-old man who had been receiving warfarin for atrial fibrillation, underwent emergency thrombectomy. A central venous catheter (CVC) was inserted via the left subclavian vein, and heparin was administered to prevent preoperative and postoperative thrombotic events. After an uneventful thrombectomy, the patient was transferred to the intensive care unit (ICU). On the second postoperative day, the patient developed syncope and his blood pressure and oxygen saturation decreased. A computed tomography (CT) revealed a huge hematoma under the pectoralis major muscle. The patient was then treated with continuous renal replacement therapy and mechanical ventilation for multiorgan dysfunction syndrome, which developed due to hemorrhagic shock in the ICU. These findings suggest that when a CVC is inserted in patients requiring anticoagulant therapy, the possible risk of excessive bleeding must be carefully considered. Further, choosing a proper insertion site and performing an ultrasound-guided aspiration may be helpful in preventing these complications.http://ekja.org/upload/pdf/kjae-67-358.pdfanticoagulantscentral venous catheterhematomahemorrhagic shock |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Boo-Young Hwang Eunsoo Kim Won-Sung Kim Ah-Reum Cho Mi-Jung Cho Chung-Won Lee |
spellingShingle |
Boo-Young Hwang Eunsoo Kim Won-Sung Kim Ah-Reum Cho Mi-Jung Cho Chung-Won Lee Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report Korean Journal of Anesthesiology anticoagulants central venous catheter hematoma hemorrhagic shock |
author_facet |
Boo-Young Hwang Eunsoo Kim Won-Sung Kim Ah-Reum Cho Mi-Jung Cho Chung-Won Lee |
author_sort |
Boo-Young Hwang |
title |
Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report |
title_short |
Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report |
title_full |
Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report |
title_fullStr |
Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report |
title_full_unstemmed |
Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report |
title_sort |
hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report |
publisher |
Korean Society of Anesthesiologists |
series |
Korean Journal of Anesthesiology |
issn |
2005-6419 2005-7563 |
publishDate |
2014-11-01 |
description |
A 74-year-old man who had been receiving warfarin for atrial fibrillation, underwent emergency thrombectomy. A central venous catheter (CVC) was inserted via the left subclavian vein, and heparin was administered to prevent preoperative and postoperative thrombotic events. After an uneventful thrombectomy, the patient was transferred to the intensive care unit (ICU). On the second postoperative day, the patient developed syncope and his blood pressure and oxygen saturation decreased. A computed tomography (CT) revealed a huge hematoma under the pectoralis major muscle. The patient was then treated with continuous renal replacement therapy and mechanical ventilation for multiorgan dysfunction syndrome, which developed due to hemorrhagic shock in the ICU. These findings suggest that when a CVC is inserted in patients requiring anticoagulant therapy, the possible risk of excessive bleeding must be carefully considered. Further, choosing a proper insertion site and performing an ultrasound-guided aspiration may be helpful in preventing these complications. |
topic |
anticoagulants central venous catheter hematoma hemorrhagic shock |
url |
http://ekja.org/upload/pdf/kjae-67-358.pdf |
work_keys_str_mv |
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