MICU rounds


Avoiding harm: Central venous access in Kartagener syndrome and other vascular anomalies

Brad Snodgrass MD, FACP, Victoria Chu MS, MBA

ABSTRACT

Placement of internal jugular catheters is more likely to be complicated if a left-sided approach is used, assuming normal anatomy. Kartagener syndrome is the sine qua non of sidedness confusion and results in cognitive challenges that increase the risk of adverse patient outcomes. The altered anatomy can cause profound disorientation from our usual processes. In normal circumstances the right-sided approach is used for placement of internal jugular catheters, but in Kartagener syndrome the left-sided approach should be preferred. Surgical volume and use of ultrasound guided techniques are positively correlated with better outcomes. Clinical experience may be a detriment to performance. Knowledge of these issues will help clinicians maintain vigilance and avoid error.

Keywords: Kartagener syndrome, central venous access, superior vena cava, landmark technique, internal jugular vein catheterization cognitive bias




Article citation: Snodgrass B, Chu V. Avoiding harm: Central venous access in Kartagener syndrome and other vascular anomalies. The Southwest Respiratory and Critical Care Chronicles 2021;9(41):40–43

From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas

Submitted: 9/21/2021

Accepted: 9/29/2021

Reviewer: Kenneth Nugent MD

Conflicts of interest: none

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