Recurrent Bilateral Pleural Effusions Secondary to Superior Vena Cava Obstruction as a Complication of Central Venous Catheterization
- 1 July 1983
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in Pediatrics
- Vol. 72 (1) , 109-113
- https://doi.org/10.1542/peds.72.1.109
Abstract
Five babies (birth wt 730-1120 g) who developed bilateral pleural effusions as a complication of the use of central venous catheters are described. The effusions occurred 7-19 days after initial placement or change of a central venous catheter. All required repeated thoracenteses to remove fluid accumulation of up to 200 ml/kg per d [day]. The fluid was a clear transudate, but it became chylous when feedings were given. Venograms and autopsies demonstrated obstruction of the superior vena cava with drainage occurring through collaterals to the azygous vein and inferior vena cava. Silastic gas-sterilized catheters implanted in animals for 4 and 24 h showed fibrin deposition when scanned by EM. No deposition occurred on autoclaved catheters after 4 h and there was minimal deposition after 24 h. The pleural effusions apparently resulted from obstruction of thoracic lymph flow into the venous system. Vena caval thrombosis may have been enhanced by 2-chloroethanol or ethylene oxide residues from gas sterilization of Silastic catheters.This publication has 3 references indexed in Scilit:
- Lethal chylothoraces due to superior vena caval thrombosis in infantsAmerican Journal of Roentgenology, 1981
- Complications of central venous catheterizationAmerican Journal of Roentgenology, 1979
- The lymphographic anatomy of chylothoraxThe British Journal of Radiology, 1978