Postganglionic Hornerʼs syndrome after insertion of a pulmonary artery catheter through the internal jugular vein

Abstract

Invasive hemodynamic monitoring by pulmonary arterial (PA) catheterization is commonly used to guide fluid and vasoactive drug therapy in the critically ill patient (1). However, multiple catheter-related complications have been described (1–3). It might be anticipated from the proximity of arterial and cervical sympathetic nerve structures to the internal jugular vein that local complications during insertion can lead to ipsilateral injury. Nevertheless, the spectrum of neurologic injury is incompletely defined. We report the first instance of a postganglionic Homer's syndrome, confirmed by pharmacologie localization (4–6), developing after otherwise uneventful percutaneous insertion of a PA catheter via the ipsilateral internal jugular vein.