FALLIBILITY OF PERSISTENT BLOOD RETURN FOR CONFIRMATION OF INTRAVASCULAR CATHETER PLACEMENT IN PATIENTS WITH HEMORRHAGIC THORACIC EFFUSIONS

Two patients are described with hemorrhagic thoracic effusions who req uired central venous catheterization. Presumed subclavian and internal jugular vein cannulation, ipsilateral to the hemorrhagic thoracic eff usions, was confirmed by the operators in each case by the persistent aspiration of blood. Subsequent clinical and radiologic evaluation rev ealed that the vascular catheters were introduced into the pleural spa ce. In both individuals, the persistent aspiration of extravascular he morrhagic fluid mimicked intravascular catheter positioning. Physician s treating patients with hemorrhagic thoracic effusions need to be awa re of this potential complication that can result in the delayed resus citation of hemodynamically unstable patients.