Hemothorax After Retroclavicular Approach to the Infraclavicular Region in a Critically Ill Patient: A Case Report

Ribeiro, Sara; Pombo, André; Lages, Neusa; Correia, Carlos; Teixeira, Carla Margarida

Publication

Hemothorax After Retroclavicular Approach to the Infraclavicular Region in a Critically Ill Patient: A Case Report

2023-12Journal article

dc.contributor.author	Ribeiro, Sara
dc.contributor.author	Pombo, André
dc.contributor.author	Lages, Neusa
dc.contributor.author	Correia, Carlos
dc.contributor.author	Teixeira, Carla Margarida
dc.date.accessioned	2024-06-18T13:04:16Z
dc.date.available	2024-06-18T13:04:16Z
dc.date.issued	2023-12
dc.description.abstract	The retroclavicular approach to the infraclavicular region (RAPTIR) is a recently described locoregional technique for upper limb analgesia that offers advantages over the classic infraclavicular block. RAPTIR is considered an effective and easy-to-perform block associated with few complications and better patient comfort. We present a case of a critically ill patient with thoracic and upper limb trauma. Despite multimodal analgesia, the patient developed delirium and experienced suboptimal pain control. An ultrasound-guided continuous RAPTIR block was performed, resulting in improved pain scores and delirium control. Twenty-four hours post block, the patient presented with dyspnea and chest pain, leading to the diagnosis of hemothorax. Chest computed tomography angiography revealed no vascular damage. The perineural catheter was removed 48 hours after its placement and the patient had a satisfactory recovery without long-term complications. The RAPTIR requires the needle to pass underneath the clavicle's acoustic shadow, putting the structures beneath the clavicle at risk of injury. Cadaver studies have raised concerns about potential vascular complications of the RAPTIR in a noncompressible location. This case highlights, for the first time, a rare but serious complication of the RAPTIR, demonstrating the potential risks of passing the needle through a blind spot	pt_PT
dc.description.version	info:eu-repo/semantics/publishedVersion	pt_PT
dc.identifier.citation	Ribeiro S, Pombo A, Lages N, Correia C, Teixeira C. Hemothorax After Retroclavicular Approach to the Infraclavicular Region in a Critically Ill Patient: A Case Report. Cureus. 2023;15(12):e49876. doi:10.7759/cureus.49876	pt_PT
dc.identifier.doi	10.7759/cureus.49876	pt_PT
dc.identifier.issn	2168-8184
dc.identifier.uri	http://hdl.handle.net/10400.16/2974
dc.language.iso	eng	pt_PT
dc.peerreviewed	yes	pt_PT
dc.publisher	Cureus, Inc.	pt_PT
dc.relation.publisherversion	https://www.cureus.com/articles/207602-hemothorax-after-retroclavicular-approach-to-the-infraclavicular-region-in-a-critically-ill-patient-a-case-report#!/	pt_PT
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/	pt_PT
dc.subject	brachial plexus block	pt_PT
dc.subject	case report	pt_PT
dc.subject	critical care	pt_PT
dc.subject	delirium	pt_PT
dc.subject	hemothorax	pt_PT
dc.subject	pain management	pt_PT
dc.subject	regional anesthesia	pt_PT
dc.subject	trauma	pt_PT
dc.subject	upper extremity	pt_PT
dc.title	Hemothorax After Retroclavicular Approach to the Infraclavicular Region in a Critically Ill Patient: A Case Report	pt_PT
dc.type	journal article
dspace.entity.type	Publication
oaire.citation.conferencePlace	United States of America	pt_PT
oaire.citation.issue	12	pt_PT
oaire.citation.startPage	e49876	pt_PT
oaire.citation.title	Cureus	pt_PT
oaire.citation.volume	15	pt_PT
person.familyName	Teixeira
person.givenName	Carla Margarida
person.identifier.ciencia-id	A61F-CDBA-4EE2
person.identifier.orcid	0000-0002-9581-0756
person.identifier.scopus-author-id	55908810500
rcaap.rights	openAccess	pt_PT
rcaap.type	article	pt_PT
relation.isAuthorOfPublication	a94d3ce9-c815-40e6-a0b4-63142f42b61d
relation.isAuthorOfPublication.latestForDiscovery	a94d3ce9-c815-40e6-a0b4-63142f42b61d