Correspondence  |   February 2018
Distal Subclavian Cannulation and Extravasation
Author Notes
  • University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Gierlbt2@upmc.edu
  • This letter was sent to the author of the original article referenced above, who did not respond.—Evan D. Kharasch, M.D., Ph.D., Editor-in-Chief.
    This letter was sent to the author of the original article referenced above, who did not respond.—Evan D. Kharasch, M.D., Ph.D., Editor-in-Chief.×
  • (Accepted for publication November 2, 2017.)
    (Accepted for publication November 2, 2017.)×
Article Information
Correspondence
Correspondence   |   February 2018
Distal Subclavian Cannulation and Extravasation
Anesthesiology 2 2018, Vol.128, 423. doi:10.1097/ALN.0000000000002009
Anesthesiology 2 2018, Vol.128, 423. doi:10.1097/ALN.0000000000002009
In reading “Examining the Edges of Extravasation”1  I noticed that the subclavian catheter enters the skin quite laterally. A more lateral cannulation often tunnels through the pectoral musculature, the tail of the breast in a female patient, and a thicker portion of adipose tissue than would a more medially placed catheter. These structures are mobile and allow for the distance from the skin to the vessel to change as patients are positioned, bathed, perform physical therapy, or move of their own volition. Such motion may result in a significant portion of the proximal catheter, and thus the proximal port, leaving the vessel and causing the subsequent extravasation.
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