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Knotting and Kinking of the Guidewire during Central Venous Catheterization: A Case Report
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Deokkyu Kim, Ji Hye Lee, Dong Chan Kim, Hyungsun Lim, Seonghoon Ko, Ji Seon Son
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Korean J Crit Care Med. 2011;26(1):38-40.
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DOI: https://doi.org/10.4266/kjccm.2011.26.1.38
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 Abstract
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- Central venous catheterization is often necessary to manage critically ill patients in the intensive care unit and some surgical patients in the operating room. However, this procedure can lead to various complications. We experienced a case of subclavian venous catheterization that was complicated by looping, kinking, knotting, and entrapment of the guidewire. We were able to identify the extravascular looping and knotting of the guidewire under fluoroscopy and consequently removed it successfully. We suggest that a guidewire should be confirmed by fluoroscopic imaging if it has become entrapped.
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Effective Management for Incidental Detachment of the Pilot Balloon on the Endotracheal Tube: A Case Report
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Hyungsun Lim, Ji Seon Son, Hyun Ho Choi, Deokkyu Kim, Jeong Woo Lee, Seonghoon Ko
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Korean J Crit Care Med. 2010;25(1):27-29.
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DOI: https://doi.org/10.4266/kjccm.2010.25.1.27
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Abstract
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- A 57-year-old female with lumbar spinal stenosis at L4-S1 was scheduled to undergo posterolateral interbody fusion.
Intubation with a 7.0 size ID cuffed reinforced tracheal tube (Mallinckrodt(TM), Mallinckrodt Medical Atholen, Ireland) was uncomplicated, and any air leakage was not detected at that time. Two hours after the start of operation, an air leak was apparent at the trachea during ventilation in the prone position. Closer inspection of the inflation tube and pilot balloon showed that the pilot balloon had become detached. Because she was being operated on in the prone position, and ventilation was only possible at a less than optimal state, we attempted to fix this without having to reintubate the patient's trachea. Our solution involved inserting a 21-gauge needle into the inflation tube and a handheld aneroid manometer was then connected to it. The tube cuff was thereafter inflated up to a pressure of 20 cmH2O. In conclusion, careful manipulation is recommended when performing intubation and a needle connector may help secure the airway if the pilot balloon becomes detached during the procedure.
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