What is the most serious risk associated with central line placement?

The most serious risk associated with central line placement is pneumothorax. This complication occurs when the lung is inadvertently punctured during the insertion of the central line, typically when accessing the subclavian or jugular veins. A pneumothorax can lead to a collapse of the lung, which can be life-threatening if not recognized and treated promptly. Signs of pneumothorax may include sudden chest pain and shortness of breath, and it typically requires immediate medical intervention.

While infections, thrombosis, and catheter misplacement are significant risks associated with central lines, they often do not present the immediate and severe consequence that pneumothorax can. Infections can be serious but may develop over time, and thrombosis typically manifests as a complication rather than an acute emergency. Catheter misplacement, while critical to correct, does not usually result in as immediate a threat to life as pneumothorax. Thus, the potential for a pneumothorax to lead to rapid deterioration of the patient highlights its seriousness as a risk during central line placement.