Rescue of a patient with a 50 cm broken PICC tube retracted and wrapped in pulmonary artery: a case report
Article Category: Case report
Data publikacji: 30 gru 2021
Zakres stron: 445 - 450
Otrzymano: 23 gru 2020
Przyjęty: 18 lut 2021
DOI: https://doi.org/10.2478/fon-2021-0045
Słowa kluczowe
© 2021 Sha Yang et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Objective
With the increasing use of a peripherally inserted central catheter (PICC) in clinical application, the breaking of the PICC is increasing as well, which would turn into the emboli and drift to the heart and pulmonary artery, causing severe consequences. However, few cases have been reported on the rescue of patients with a broken PICC.
Patient concerns
A 33-year-old man, diagnosed with chronic hepatitis B-related decompensated cirrhosis and cryptococcal meningitis, was treated with amphotericin B combined with flucytosine and fluconazole by means of PICC catheterization. The patient was discharged with a catheter; when he returned for re-examination, a 50cm length of PICC broke and slipped into the vein after his sudden dysphoria. First aid was immediately administered, and then the intervention therapy to extricate the tube, including pulmonary artery angiography and intravascular removal of foreign matter, was performed based on the consensus of the in-hospital vein treatment group. At last, the broken PICC fragment was successfully taken out of the vessel. Re-examination after surgery showed that he recovered well.
Conclusions
Once the catheter is broken, the X-ray examination should be performed at the first instance and re-examined frequently. Moreover, the involvement of a multidisciplinary team should be formed to decide the appropriate method of treatment to ensure a successful rescue.