CHẨN ĐOÁN BIẾN CHỨNG CÒN SÓT DÂY DẪN SAU ĐẶT ỐNG THÔNG TĨNH MẠCH ĐÙI TẠI GIƯỜNG BÁO CÁO MỘT CA LÂM SÀNG

Abstract

Central venous catheter (CVC) placement is a common procedure performed for continuous invasive hemodynamic monitoring, fluid resuscitation, medication administration, and hemodialysis. This procedure can be associated with serious complications, most of which are preventable. One of these complications is the retention or migration of the stainless-steel guidewire (used in the Seldinger technique) within the bloodstream, increasing morbidity and mortality risk. In this case report, we describe a 61-year-old male patient diagnosed with septic shock (suspected gastrointestinal source), alcohol abuse, and hypertension, who underwent emergency continuous renal replacement therapy (CRRT) for acute kidney injury. A right femoral vein CVC was inserted, and a routine post-procedural chest X-ray revealed an unretained guidewire extending from the abdominal cavity to the skull base. After 23 days, when the patient’s clinical condition stabilized, the retained guidewire was successfully removed. Although no significant complications were observed in this case, retained guidewires in the vascular system pose a potentially life-threatening risk. Continuous medical training, strict supervision, and adherence to standardized safety protocols are essential in preventing this avoidable complication.