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脐静脉置管后早产儿出现心脏扩大。

Cardiomegaly in a premature neonate after venous umbilical catheterization.

作者信息

Schlapbach Luregn Jan, Pfammatter Jean-Pierre, Nelle Mathias, McDougall Felicity Jane

机构信息

Division of Neonatology, Department of Pediatrics, University of Berne, Berne, Switzerland.

出版信息

Eur J Pediatr. 2009 Jan;168(1):107-9. doi: 10.1007/s00431-008-0704-3. Epub 2008 Apr 1.

Abstract

Umbilical venous catheters allow rapid central access in neonates, but may be associated with various complications. We present a case of a newborn with pericardial effusion following umbilical venous catheterization. An extremely low birth weight infant was intubated for respiratory distress syndrome and had umbilical venous and arterial lines in place. Massive cardiomegaly was noted on the subsequent chest X-ray. Echocardiography revealed a large pericardial effusion without signs of tamponade. After removing the catheter, the effusion gradually resolved. While pericardial effusion is a well-known complication of percutaneous long central lines, only a few case reports have documented sudden cardiovascular compromise associated with umbilical venous catheters. Pericardial effusion may be asymptomatic and should be suspected in infants with central catheters and progressive cardiomegaly. The prompt removal of catheters and, if signs of cardiac tamponade are present, emergency pericardiocentesis may prove to be life-saving.

摘要

脐静脉导管可使新生儿快速获得中心静脉通路,但可能伴有各种并发症。我们报告一例新生儿在脐静脉置管后发生心包积液的病例。一名极低出生体重儿因呼吸窘迫综合征行气管插管,同时留置了脐静脉和动脉导管。随后的胸部X线检查发现心脏明显增大。超声心动图显示大量心包积液,但无心脏压塞征象。拔除导管后,积液逐渐消退。虽然心包积液是经皮长中心静脉导管的一种常见并发症,但仅有少数病例报告记录了与脐静脉导管相关的突发心血管功能障碍。心包积液可能无症状,对于留置中心静脉导管且心脏进行性增大的婴儿应怀疑有心包积液。及时拔除导管,如果出现心脏压塞征象,紧急心包穿刺术可能挽救生命。

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