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Korean J Anesthesiol. 2016 Oct;69(5):532-534. English. Case Report.
Rao PB , Singh N , Samson S .
Department of Anesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, Bhubaneswar, India.
Department of Anesthesiology, Pondicherry Institute of Medical Sciences, Pondicherry, India.

A 56-year-old man on maintenance hemodialysis was admitted to the intensive care unit with septic shock and coagulopathy. As there was a dialysis catheter in the right internal jugular vein, the left internal jugular vein was cannulated with a central venous catheter to initiate vasopressor therapy. A chest X-ray showed formation of a catheter loop inside the left brachiocephalic vein, probably due to hindrance by the dialysis catheter. This report describes the hurdles encountered, repeated cannulation attempts, and serial chest X-ray findings required to obtain acceptable placement of the catheter tip.

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