Chest radiograph: lines and tubes in intensive care

Case contributed by Dr Justyna Swol

Presentation

ICU patient with sepsis, fever and renal failure

Patient Data

Age: 50
Gender: Male

Intubated ICU patient, tracheal tube above the tracheal bifurcation, gastric feeding tube in situ, 3 ECG electrodes. There is a central line in the right jugular vessel and two central lines with projection on upper vena cava and right atrium. Bilateral pleural effusions and atelectasis.   

Case Discussion

After admission to the ICU the central line was placed into the right jugular vein. After 6 days of the intensive care treatment fever and hemodynamic instability occured corresponding to sepsis with renal failure. Intensivist indicated to place the new central line and the new catheter for the continous renal replacement therapy (CRRT), both lines into the left jugular vein.

The radiograph confirms the position of the new lines on the opposite site before the catheter removal on the right site due to the supposed catheter associated blood stream infection.

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Case Information

rID: 48275
Case created: 28th Sep 2016
Last edited: 28th Sep 2016
Systems: Chest, Vascular
Inclusion in quiz mode: Excluded

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