Pressure-created communication between lumens of a multilumen venous catheter.

ABSTRACT

OBJECTIVE: To describe the inadvertent creation of a connection between lumens of a multilumen catheter by use of an in-line intravenous hand pressure pump. DESIGN: Case report. SETTING: Operating theater. PATIENT All lumens of a 4F triple lumen catheter were verified patent by irrigation with saline before insertion into an internal jugular vein of an 18-mo-old child undergoing cardiac surgery. During surgery, the flushing of saline into one lumen of the catheter by means of an in-line hand pressure pump caused registration of >300 mm Hg pressure recorded from another lumen. The connections to these two lumens were then reversed. Repeated flushing also caused registration of pressure >300 mm Hg. On removal of the catheter at the end of surgery, flushing of one lumen caused fluid to emerge from the wrong exit hole as the appropriate exit hole was blocked with blood clot. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Pressure measurement in intravenous catheter lumens. Greater than 300 mm Hg was recorded during flushing with an inline hand pressure pump. CONCLUSIONS: High pressure created by use of an in-line intravenous hand pressure pump may cause creation of a communication between lumens of multilumen catheters.