Ultrasound-guided placement of a midline catheter in a patient with extensive postburn contractures: A Case report. Issue 3 (January 2019)

• Record Type: Journal Article
• Authors: Yokota, Taisuke; Tokumine, Joho; Lefor, Alan Kawarai; Hasegawa, Ayako; Yorozu, Tomoko; Asao, Takayuki
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 98:Issue 3(2019)
• Publication Date: 2019-01
• Subjects: burn -- central venous catheter -- midline -- peripherally inserted central venous catheter -- scar contracture; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000014208
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Obtaining venous access in a patient with extensive postburn scar contractures is a challenge. Patient concerns: A 39-year-old woman suffered a burn 2 years previously with a total body surface area burn of 93%, and a burn index of 85. Reconstructive surgery was previously performed 39 times. Split-thickness skin grafting to the neck was planned. She had no accessible peripheral veins. Diagnosis: Difficult venous access due to excessive burn scar contractures. Interventions: Central venous catheterization was considered impossible even with ultrasound guidance. We placed a midline catheter for intraoperative venous access in a patient with extensive burn scar contractures. The midline catheter is a peripheral venous catheter placed in an arm vein. Outcomes: We successfully placed a midline catheter in the right brachial vein. This catheter was used for 24 days without difficulty. Lessons: The midline catheter is a viable choice in patients with difficult vascular access due to extensive postburn scar contractures.