A 70 year old patient comes in with septic shock. She is febrile, tachycardic, hypotensive, tachypneic, and hypoxemic. Her labs show a leukocytosis, elevated lactate, and elevated procalcitonin. Chest X-ray shows a right lower lung focal opacity. She is fluid resuscitated with 5 liters of crystalloid but still has refractory hypotension. The emergency medicine intern puts in a right internal jugular central venous catheter to start norepinephrine. Later, a KUB is taken which is shown above.
Challenge: What complication happened here?
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Whoops
The KUB shows a guidewire used in central line placement. Wire embolism is a rare complication that occurs when control of the guidewire is lost.
Source: ijccm.org.
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