Cases & Commentaries
Admitted to the ICU with septic shock, a man with a transplanted kidney developed hypotension and required new central venous access. Since providers anticipated using the patient's left internal jugular vein catheter for re-starting hemodialysis, (making it unsuitable to use for resuscitation), the ICU team placed the central line in the right femoral vein. However, they failed to recognize that his transplanted kidney was on the right side, which meant that femoral catheter placement on that side was contraindicated. In the accompanying commentary, Barbara Haas, MD, PhD, of the University of Toronto, and Lesley Gotlib Conn, PhD, of Sunnybrook Research Institute, discuss how the intensivist-led model of critical care delivery may have unexpected effects and highlight the need for research to examine communication between ICU teams and consulting teams.