¿Es suficiente la guía por ultrasonido? Malposición de catéter venoso central a pesar de la colocación ecoguiada.

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Title: ¿Es suficiente la guía por ultrasonido? Malposición de catéter venoso central a pesar de la colocación ecoguiada.
Alternate Title: Is ultrasound guidance sufficient? Central venous catheter malpositioning despite ultrasound-guided placement.
Authors: Tirapé-Castro, Hugo Arturo1 hugo.tirape@gmail.com, Aguinsaca-Guachanama, Lorena Alexandra2, Macías-Valdez, Ney Asdrúbal2, Paredes-Peña, Juan Carlos3, Cajamarca-Sacta, Lía Cristina4
Source: Acta Medica Colombiana. ene-mar2026, Vol. 51 Issue 1, p1-5. 5p.
Subjects: CENTRAL venous catheters, CENTRAL venous catheterization, ELECTROCARDIOGRAPHY, ULTRASONIC imaging, CENTRAL venous pressure, CATHETERIZATION, DIAGNOSTIC imaging
Abstract (English): Introduction: real-time ultrasound guidance has reduced the complications of central venous catheterization; however, catheter tip malpositioning persists and may be associated with device malfunction and thromboembolic events. Case presentation: we present two cases of "U-shaped" malpositioning of central venous catheters placed under ultrasound guidance, one through the right subclavian and the other through the left internal jugular, which required immediate relocation after x-ray confirmation. Both patients recovered without complications. Conclusion: recent literature shows residual malpositioning despite the use of ultrasound, indicating that immediate verification improves with the addition of a second bedside method, such as intracavitary electrocardiography, an agitated saline contrast study, or central venous pressure measurement. These cases illustrate the limitations of only using ultrasound and support the implementation of combined algorithms to reduce adverse events. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: la guía ecográfica en tiempo real ha disminuido las complicaciones de la canalización venosa central; sin embargo, la malposición de la punta del catéter persiste y puede asociarse con disfunción del dispositivo y eventos tromboembólicos. Presentación de caso: se presentan dos casos de malposición en "U" de catéter venoso central colocados con técnica ecoguiada, uno por acceso subclavio derecho y otro por yugular interna izquierda, que requirieron recolocación inmediata tras confirmación radiográfica. Ambos pacientes evolucionaron sin complicaciones. Conclusión: la literatura reciente muestra tasas residuales de malposición pese al uso de ultrasonido y evidencia que la verificación inmediata mejora al añadir un segundo método "bedside", como electrocardiografía intracavitaria, test de suero salino agitado o medición de presión venosa central. Estos casos ilustran la limitación del ultrasonido como estrategia única y respaldan la implementación de algoritmos combinados para reducir eventos adversos. [ABSTRACT FROM AUTHOR]
Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: ¿Es suficiente la guía por ultrasonido? Malposición de catéter venoso central a pesar de la colocación ecoguiada.
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  Data: Is ultrasound guidance sufficient? Central venous catheter malpositioning despite ultrasound-guided placement.
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  Data: <searchLink fieldCode="AR" term="%22Tirapé-Castro%2C+Hugo+Arturo%22">Tirapé-Castro, Hugo Arturo</searchLink><relatesTo>1</relatesTo><i> hugo.tirape@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Aguinsaca-Guachanama%2C+Lorena+Alexandra%22">Aguinsaca-Guachanama, Lorena Alexandra</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Macías-Valdez%2C+Ney+Asdrúbal%22">Macías-Valdez, Ney Asdrúbal</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Paredes-Peña%2C+Juan+Carlos%22">Paredes-Peña, Juan Carlos</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Cajamarca-Sacta%2C+Lía+Cristina%22">Cajamarca-Sacta, Lía Cristina</searchLink><relatesTo>4</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Acta+Medica+Colombiana%22">Acta Medica Colombiana</searchLink>. ene-mar2026, Vol. 51 Issue 1, p1-5. 5p.
– Name: Subject
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  Group: Su
  Data: <searchLink fieldCode="DE" term="%22CENTRAL+venous+catheters%22">CENTRAL venous catheters</searchLink><br /><searchLink fieldCode="DE" term="%22CENTRAL+venous+catheterization%22">CENTRAL venous catheterization</searchLink><br /><searchLink fieldCode="DE" term="%22ELECTROCARDIOGRAPHY%22">ELECTROCARDIOGRAPHY</searchLink><br /><searchLink fieldCode="DE" term="%22ULTRASONIC+imaging%22">ULTRASONIC imaging</searchLink><br /><searchLink fieldCode="DE" term="%22CENTRAL+venous+pressure%22">CENTRAL venous pressure</searchLink><br /><searchLink fieldCode="DE" term="%22CATHETERIZATION%22">CATHETERIZATION</searchLink><br /><searchLink fieldCode="DE" term="%22DIAGNOSTIC+imaging%22">DIAGNOSTIC imaging</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Introduction: real-time ultrasound guidance has reduced the complications of central venous catheterization; however, catheter tip malpositioning persists and may be associated with device malfunction and thromboembolic events. Case presentation: we present two cases of "U-shaped" malpositioning of central venous catheters placed under ultrasound guidance, one through the right subclavian and the other through the left internal jugular, which required immediate relocation after x-ray confirmation. Both patients recovered without complications. Conclusion: recent literature shows residual malpositioning despite the use of ultrasound, indicating that immediate verification improves with the addition of a second bedside method, such as intracavitary electrocardiography, an agitated saline contrast study, or central venous pressure measurement. These cases illustrate the limitations of only using ultrasound and support the implementation of combined algorithms to reduce adverse events. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Introducción: la guía ecográfica en tiempo real ha disminuido las complicaciones de la canalización venosa central; sin embargo, la malposición de la punta del catéter persiste y puede asociarse con disfunción del dispositivo y eventos tromboembólicos. Presentación de caso: se presentan dos casos de malposición en "U" de catéter venoso central colocados con técnica ecoguiada, uno por acceso subclavio derecho y otro por yugular interna izquierda, que requirieron recolocación inmediata tras confirmación radiográfica. Ambos pacientes evolucionaron sin complicaciones. Conclusión: la literatura reciente muestra tasas residuales de malposición pese al uso de ultrasonido y evidencia que la verificación inmediata mejora al añadir un segundo método "bedside", como electrocardiografía intracavitaria, test de suero salino agitado o medición de presión venosa central. Estos casos ilustran la limitación del ultrasonido como estrategia única y respaldan la implementación de algoritmos combinados para reducir eventos adversos. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.36104/amc.2026.4804
    Languages:
      – Code: spa
        Text: Spanish
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    Subjects:
      – SubjectFull: CENTRAL venous catheters
        Type: general
      – SubjectFull: CENTRAL venous catheterization
        Type: general
      – SubjectFull: ELECTROCARDIOGRAPHY
        Type: general
      – SubjectFull: ULTRASONIC imaging
        Type: general
      – SubjectFull: CENTRAL venous pressure
        Type: general
      – SubjectFull: CATHETERIZATION
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      – SubjectFull: DIAGNOSTIC imaging
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      – TitleFull: ¿Es suficiente la guía por ultrasonido? Malposición de catéter venoso central a pesar de la colocación ecoguiada.
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            NameFull: Tirapé-Castro, Hugo Arturo
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            NameFull: Aguinsaca-Guachanama, Lorena Alexandra
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            NameFull: Macías-Valdez, Ney Asdrúbal
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            NameFull: Paredes-Peña, Juan Carlos
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            NameFull: Cajamarca-Sacta, Lía Cristina
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              Text: ene-mar2026
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              Y: 2026
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