Tension Pneumothorax after Attempting Insertion of a Central Venous Catheter

A 17-year-old female patient was admitted to the emergency department of our hospital with dyspnea, which had presented 1 day earlier but had worsened despite treatment at another hospital. Before the onset of dyspnea, she had been undergoing follow-up in our pediatrics department because of repetitive aspiration pneumonia associated with cerebral palsy. On admission, her vital signs revealed a blood pressure of 60/40 mmHg, a temperature of 38°C, and a heart rate of 185 bpm. Arterial blood gas analysis showed pH 7.09, pCO2 67 mmHg, pO2 53 mmHg, and O2 saturation 72%. Central venous catheterization was attempted under mechanical ventilation into the right subclavian vein without success. While undergoing another catheterization into the left subclavian vein, the patient went into cardiac arrest and required cardiopulmonary resuscitation (CPR).