Massive Hemothorax following Canylation of the Subcalvian Vein – a Case Review

Czech version

Authors: Michal Černý; K. Havlíček; L. Sákra; J. Flašar
Authors‘ workplace: Chirurgická klinika Krajské nemocnice Pardubice, a. s., přednosta: doc. MUDr. K. Havlíček, CSc.
Published in: Rozhl. Chir., 2008, roč. 87, č. 7, s. 376-379.
Category: Monothematic special - Original

Overview

Introduction:
Cannulation v. subclavia is connected with many complications. Haemothorax is occurs approximately in 2% of cases. Surgical revision is indicated immediately if a major blood loss or a circulation insufficiency occur. Surgical treatment of bleeding in cupola of pleural cavity is due to its bad accesability difficult and conventional surgical methods aren’t sufficient. In these cases one can use local haemostyptic.

Case report:
The authors present a case review of a 36-years old patient with a developed massive haemothorax on the left side post a catheterization of v. subclavia. During surgical revision it was found out that a source of bleeding in superior thoracic aperture is present. It wasn’t able to be stopped by classical surgical procedure. TachoSil and Arista preparations were used in this case with a good effect.

Key words:
Central Venous Cathetrization – Haemothorax – Local hemostyptic

Sources

1. Drábková, J. Centrální žilní katétry – funkce, základy zavádění a ošetřování. MSM, 2004.

2. Taylor, R. W., Palagiri, A. V. Central Venous Catheterization: Concise Definitive. Review Posted 05/16/2007.

3. Larsen R. Anestezie. Grada, 2004, str. 672–675.

4. Ševčík, P., Černý, V. Vítovec, J. Intenzivní medicína. Praha, Galén-Karolinum, 2000. Kap. 3., odst. 3.3.3 Přístupy do centrálního žilního řečiště, s. 14–15.

5. Nakamura, V., Allaouchiche, B., Mahon, L., Lansiaux, S., Chasard, D. Pulmonary hematoma: unusual complication of central catheterization. Ann. Fr. Anesth. Reanim., 2000, Nov;19(9): 678–681.

6. Ueki, R., Okutani, R., Fukushima, A., Kurehara, H., Sasaki, K., Tashiro, C. Iatrogenic extrapleural hematoma. Masui, 2000, Jan; 49(1): 37–39.

7. Šiller, J., Havlíček, K., Motyčka, V. Tupá poranění hrudníku, patofyziologické aspekty a léčba. IV. slovenský chirurgický kongres s medzinárodnou účasťou a XXXV. spoločný kongres slovenských a českých chirurgov, 6.–8. 9. 2006, Nitra. Zborník abstraktov, s. 56.

8. Motyčka, V., Šiller, J., Havlíček, K. Urgentní chirurgická intervence u úrazů hrudníku. VIII. ostravské traumatologické dny, říjen 2006, sborník abstrakt, s. 29–30.

9. Šiller, J., Havlíček, K., Motyčka, V. Naše zkušenosti s videotorakoskopií. 4. mezinárodní konference CMCIE Miniinvaz. Terap., 2000; 5: 43.

10. Kondler, R., Fuchs, T. Clinical application of a human-collagen fleece as haemostatic agent. Arzneimittelforschung, 1989, Mar; 39(3): 401–403.

11. Haas, S. The use of a surgical patch coated with human coagulation factors in surgical routine: a multicenter postauthorization surveillance. Clin. Appl. Thromb. Hemost., 2006; 12(4): 445–450.

12. Havlíček, K., Tecl, F., Šiller, J. Fibrin sealant in pulmonary and thoracic surgary. Scr. Med., 1994; 67: 15–19.

13. Nordentoft, T., Romer, J., Sorensen, M. Sealing of gastrointestinal anastomoses with a fibrin glue-coated collagen patch:a safety study. J. Invest. Surg., 2007 Nov-Dec; 20(6): 363–369.

14. Meisner, H., Struck, E., Schmidt-Habelmann, P., Sebening, F. Fibrin seal application. Clinical experience. Thorac. Cardiovasc. Surg., 1982, Aug; 30(4): 232–233.

15. Silverstein, M. E., Chvapil, M. Experimental and clinical experiences with collagen fleece as a hemostatic agent. J. Trauma, 1981, May; 21(5): 388–393.

16. Medscape Medical News FDA Approvals: Aptima, Harmony Bionic Ear, Arista AH.

17. Izbicki, J. R., Kreusser, T., Trupka, A., et al. Fibrin-coated collagen fleece in thoracic surgery. Initial clinical experience. Chirurg, 1991, Jun; 62(6): 479–481.

18. Getman V., Devyatko E., Wolner E., et al. Fleece bound sealing prevents pleural adhesions. Interact. CardioVasc. Thorac. Surg., 2006; 5: 243–246.