Kalen V, Medige T A, Rinsky L A
Department of Orthopaedics, College of Medicine, University of Florida, Gainesville 32610.
J Bone Joint Surg Am. 1991 Dec;73(10):1503-6.
Pericardial tamponade from an indwelling central venous catheter developed in four orthopaedic patients. Two of these patients died acutely, and the other two sustained severe anoxic brain injury. The early signs of tamponade include tachycardia, hypotension, and increased central venous pressure. The outcome most often is fatal. When a central venous catheter has been placed incorrectly or has migrated, it can perforate the heart and produce pericardial tamponade. To avoid this complication, the tip of the catheter must be placed within the superior vena cava rather than the right atrium, and the position of the catheter must be ascertained with a radiograph of the chest. Prompt recognition and treatment of pericardial tamponade are imperative if a disastrous outcome is to be prevented.
4名骨科患者因留置中心静脉导管发生心包填塞。其中2名患者急性死亡，另外2名患者遭受严重缺氧性脑损伤。心包填塞的早期体征包括心动过速、低血压和中心静脉压升高。其后果通常是致命的。当中心静脉导管放置不当或移位时，可能会穿透心脏并导致心包填塞。为避免这种并发症，导管尖端必须置于上腔静脉内而非右心房内，且必须通过胸部X光片确定导管位置。若要防止灾难性后果的发生，必须及时识别和治疗心包填塞。
