Where has the Central Venous Catheter Gone? Common Catheter Malpositions Occurring in a Tertiary Care Teaching Hospital

Central Venous Catheterization (CVC) is a common procedure in intensive care units, operation theatres, access for emergency dialysis and long term chemotherapy. They are usually placed from central veins like internal jugular (IJV) or subclavian (SCV) veins and peripheral sites such as basilic and femoral veins. The catheter are intended to lie at the junction of Superior Vena Cava (SVC) and right atrium for correct measurement of Central Venous Pressure (CVP) or for fluid or drug administration. Landmark technique is a frequently used technique for insertion of such catheters. Complications such as malpositions, vessel/pleural perforations, migration of guide wires are rare but potentially serious. The incidence of malpositions may range from 27% with visible complications in 6%1 to as high as 40%2 .We present the selected complications seen in our institute from over 1000 catheterization done during the period of April 2008-June 2012.