Differential diagnosis of pediatric femoral venous catheter malfunction

Approach to the differential diagnosis of femoral venous catheter malfunction:

  • Tip of catheter should be in femoral vein or inferior vena cava, otherwise tip is malpositioned
  • Catheter tip in the right atrium can lead to erosion of catheter through atrium into pericardial space causing cardiac tamponade
  • Suspect catheter is placed in artery rather than in vein when catheter does not appear to have a normal venous course
  • Suspect catheter perforation of vessel during placement when catheter does not appear to have a normal venous or arterial course
  • Catheter tip thrombosis which can extend into any adjacent vein may occur