Hematotoraks Kontralateral Paska Pemasangan Kateter Vena Sentral (KVS)

Background. Central venous catheter insertion is insertion catether into the great vessel, include superior and inferior cava vein, brachiocephalica, internal jugulare vein, subclavia vein and femoralis vein. Catheter tip can make atrial wall perforation and bleeding, and also hamatothorax and pneumothorax.
Cases. Thirty two-year-old male patients diagnose as obstuctive bowel was planned to undergo laparatomy. In purpose to evaluate the adequacy of intravascular volume the patient was inserted central venous catheter through the left subclavian vein by infraclavicular approach. A procedure of general anesthesia were performed to the patient while endotracheal tube in place. Patient was extubated post operatively and experienced short of breath in the recovery room. Post operative x-rays examination showed an opaque figure in the right hemithorax and suspected a hemorrhage. The water seal drainage was inserted and gained 700 ml blood from right lung. Along the way the treatment patient get better and discharge home.

Latar Belakang. Pemasangan kateter vena sentral didefinisikan sebagai pemasangan kateter ke dalam pembuluh darah vena besar. Akses ke pembuluh vena sentral termasuk vena cava superior, vena cava inferior, vena brakhiocephalica, vena jugularis interna, vena subclavia, vena iliaka dan vena femoralis. Ujung kateter dapat menyebabkan perforasi di dinding atrium yang tipis dan menghasilkan perdarahan serta tamponade kordis. selain itu juga dapat menyebabkan hematotoraks dan pneumothoraks.

Kasus. Kami laporkan pasien laki-laki 32 tahun dengan ileus obstruktif direncanakan dilakukan laparotomi eksplorasi. Pasien dilakukan prosedur pemasangan central venous catheter di vena subclavia kiri dengan pendekatan infraclavicula. dengan tujuan untuk pengawasan kecukupan cairan intravaskular. Pada pasien dilakukan anestesi umum dengan intubasi endotrakheal tube. Paska operasi, pasien diekstubasi dan mengalami sesak napas di ruang pemulihan. Hasil rontgen paska operasi menunjukkan gambaran opak semihomogen di hemitorak dekstra curiga perdarahan. Pasien dipasang water seal drainage dan didapatkan produk darah 700 ml. Pasien membaik selama perawatan dan diperbolehkan pulang.