BACKGROUND Severe
hypothermia has a high mortality rate and necessitates aggressive warming to save lives. One of the most effective treatments for severe
hypothermia is intravascular
rewarming. Intravascular recuperative warming can be delivered by inserting a
catheter through the cervical or femoral veins.
Catheter insertion through the femoral vein is a commonly performed procedure with fewer complications than
catheter insertion through the internal jugular vein. This procedure is commonly conducted by inserting a
central venous catheter through the femoral vein. When a
catheter is inserted through the femoral vein, a frontal abdominal radiograph is often used to confirm the position of the
catheter tip. CASE REPORT We present the case of a 58-year-old Japanese man who had severe
hypothermia. Under ultrasound guidance, a
catheter was inserted through the femoral vein into the inferior vena cava for active
rewarming. A frontal abdominal radiograph showed that a
catheter tip appeared to be in the inferior vena cava. However, a subsequent computed tomography scan revealed that the
catheter tip had been misplaced into the right ascending lumbar vein. CONCLUSIONS
Catheters may stray into the right ascending lumbar vein if they are placed through the right femoral vein. Frontal abdominal radiographs may be insufficient to confirm
catheter placement.