Jpen Parenter Enter
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Jpen Parenter Enter · Jul 1991
Case ReportsA case of intracerebral air embolism secondary to the insertion of a Hickman line.
Complications following the insertion of intravenous catheters are relatively uncommon. We report a potentially serious, hitherto unrecognized complication of Hickman line insertion, and discuss the condition.
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One hundred forty-four cancer patients harboring a central venous catheter (CVC) were prospectively investigated to assess the relationship between hub culture, clinical assessment of sepsis before removal, and CVC sepsis. In 22 patients, the CVC was removed because of clinical assessment of catheter sepsis expressed by the staff prior to the removal. For each CVC removal, peripheral blood (qualitative method), hub, and CVC tip (quantitative method) cultures were performed. ⋯ Predictive values of clinical assessment were 55% if positive and 97% if negative. Combining hub cultures and clinical assessment, the risk of sepsis varied from 2% with both evaluations negative to 89% in the case of positive clinical assessment associated with positive high-count hub. Inasmuch as the CVCs used have a disposable hub, it is possible to have an accurate diagnosis of CVC sepsis without removing the CVC.