DOI: 10.36347/sjmcr.2020.v08i01.011

Pages: 37-40

Although advance in technology undergoing central venous access and awareness of consequences have improved, unanticipated complications are still existed. Delayed onset hydrothorax caused by vascular injury from mechanical or chemical irritation of a central venous catheter to the vascular wall may occur if positioning of the catheter is suboptimal. A 55-year-old woman was undergone bypass surgery from the superficial temporal artery to the middle cerebral artery with impression of Moyamoya disease. Before surgery, a triple-lumen central venous catheter was inserted under ultrasound guidance in left subclavian vein for intraoperative hemodynamic managements. The catheter was fixed at a length of 17 cm from skin punctured site and each port of catheter was functioned optimally. After bypass surgery, she managed with coma therapy in the intensive care unit. Three days after coma therapy, she developed respiratory distress during the weaning from mechanical ventilation. Massive pleural effusion on the right chest, air-bubble with low density fluid collection on the anterior mediastinum, and small amount of pericardial effusion were shown in chest X-ray and computed tomography.