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  • Title: Aberrant position of a central venous catheter: a cause for inadequate fluid replacement in septic shock.
    Author: Krausz MM, Berlatzky J, Eimerl D, Cotev S.
    Journal: Crit Care Med; 1978; 6(5):337-8. PubMed ID: 720091.
    Abstract:
    An unusual placement of a "central" venous catheter in the porto-hemiazygous system of a cirrhotic patient in septic shock is described. The catheter was misinterpreted as being located in a central vein and served initially as a guide for volume replacement. The high central venous pressure recorded (22 cm H2O) in spite of signs of hypovolemia led to the introduction of a Swan-Ganz catheter which confirmed the presence of hypovolemia. The proper position of the central venous catheter, especially in cirrhotic patients, should not only be confirmed by plain chest x-ray but also by injection of contrast medium.
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