Jacobs W R, Zaroukian M H
Department of Medicine, Michigan State University, East Lansing 48824-1317.
JPEN J Parenter Enteral Nutr. 1991 Jul-Aug;15(4):491-3. doi: 10.1177/0148607191015004491.
Silastic central venous catheters are subject to dislodgement from a variety of causes. Only one occurrence of catheter dislodgement has been previously reported in connection with coughing. We report four additional cases of silastic central venous catheter dislodgement associated with forceful coughing paroxysms, alone or in combination with emesis or rectal tenesmus. Three episodes of catheter dislodgement occurred in adolescents or young adults with cystic fibrosis, who may constitute a particularly high-risk group. Dislodgement in two patients was asymptomatic. These case suggest that patients with frequent or severe paroxysms of increased intrathoracic pressure may be at higher risk of catheter dislodgement. Since dislodgement may be initially asymptomatic and can cause serious complications, a high index of suspicion for dislodgement in patients with silastic central venous catheters and coughing paroxysms is advised.
硅橡胶中心静脉导管会因多种原因发生移位。此前仅有一例与咳嗽相关的导管移位报告。我们报告另外四例硅橡胶中心静脉导管移位病例，这些移位与剧烈咳嗽发作有关，单独发生或与呕吐或直肠坠胀感同时出现。三例导管移位发生在患有囊性纤维化的青少年或年轻人身上，他们可能是特别高危的群体。两名患者的移位没有症状。这些病例表明，频繁或严重发作导致胸内压升高的患者可能有更高的导管移位风险。由于移位最初可能没有症状，且会导致严重并发症，因此建议对有硅橡胶中心静脉导管且有咳嗽发作的患者高度怀疑导管移位。
