A Systematic Analysis of Published Indian Case Reports of Whole Guidewire Loss During Central Venous Catheterization: Causes, Detection and Management Strategies.

Abstract

<h4>Background</h4>Guidewire loss during central venous catheterization (CVC) can lead to significant life-threatening complications. This systematic analysis reviews the published cases of guidewire loss during CVC in India, highlighting the causes, detection methods, and management strategies.<h4>Methods</h4>We searched multiple online databases, including PubMed, BMJ Case Reports, the Cochrane Database, Clinical Key, and Google Scholar, for studies published from inception to December 31, 2023. We found 18 published case studies comprising 19 cases reported from various regions in India. These studies included a diverse patient population ranging from pediatric to elderly individuals with varying clinical conditions such as cardiopulmonary diseases, infections, and trauma. The review focused on the reasons for guidewire loss, the methods of detection, removal techniques, and the involvement of specialized medical teams in managing these cases.<h4>Results</h4>The most common reasons for guidewire loss were post-dilatation. Issues like lack of operator supervision, overburden, inadvertent patient movement, inattention during placement, and nonadherence to procedural guidelines were the main causes. Assistants often detected guidewire loss immediately post-procedure while cross-checking the sterile tray. All lost guidewires can be successfully retrieved. Endovascular snaring was the most commonly used and least invasive technique.<h4>Conclusion</h4>Guidewire loss during CVC is a less-reported complication in the Indian scenario. This review depicts causes like inadequate supervision and overburden and underscores the importance of thorough training, strict procedural protocols, and multidisciplinary collaboration to curtail this preventable complication.