All three ports were aspirated and flushed with normal saline. The tip of the catheter was advanced into the right atrium, using electrocardiographic guidance. After the induction of general anesthesia, a triple-lumen catheter (Arrow-Howes Multilumen Catheter, Arrow International, Reading, PA) was atraumatically inserted into the right internal jugular vein, using Seldinger's technique. Therefore, our anesthetic plan included the insertion of a central catheter for intravenous access, aspiration of air bubbles, and monitoring of central venous pressure. This position places the patient at risk for venous air embolization (VAE). Multi-lumen catheters allow us to run several different infusion with only one access site (Image 2).
A double lumen catheter has 2 lumens while a triple lumen catheter has 3. It is also possible to design lumens with various sizes and shapes within the same catheter. In some situations, it is even possible to have more than five lumens. The neurosurgeons at our institution prefer to perform these procedures with the patient in the sitting position. A different intravenous infusion can be connected to each lumen, and the fluid will usually exit at a slightly different point along the catheter. Multi-lumen catheters often feature two or three lumens, although four and five-lumen designs are also common. A 35-yr-old, 76-kg man presented for posterior decompression craniectomy, with multiple level cervical laminectomies for Arnold-Chiari Syndrome, type 1. This family of triple lumen catheters is indicated for hemodialysis, apheresis, infusion, central venous pressure monitoring and high pressure contrast.
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