# Central Venous Catheter Misplacement Into Pleural Cavity Causing Hypertensive Pleural Effusion: A Case Report

## TL;DR

A central venous catheter was mistakenly placed into the pleural cavity, causing a life-threatening complication requiring resuscitation.

## Contribution

This case report highlights the rare but severe complication of CVC misplacement into the pleural cavity and discusses diagnostic limitations.

## Key findings

- Misplaced CVC led to hypertensive pleural effusion and cardiorespiratory arrest.
- Resuscitation was successful after two cycles of CPR.
- Imaging techniques have limitations in confirming proper CVC placement.

## Abstract

Central venous catheter (CVC) insertion is a routine procedure in the management of critically ill patients. We report a clinical case of inadvertent placement of an internal jugular vein CVC into the right pleural cavity, despite employing clinical and imaging-based techniques to ensure proper catheter positioning. Infusion of fluids and vasopressors through this misplaced catheter led to hypertensive pleural effusion and subsequent cardiorespiratory arrest. Return of spontaneous circulation was achieved after two cycles of cardiopulmonary resuscitation. While multiple imaging modalities are recommended for confirming appropriate CVC placement, each method has inherent limitations. This case highlights the imperative need for a high index of suspicion to avert such complications and pretends to review some of each method’s limitations.