Shams Vahdati Samad
Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2011;3(3):97-9. doi: 10.5681/jcvtr.2011.021. Epub 2011 Aug 20.
Haemodialysis needs a credible and recurrent access to the systemic circulation which can be accomplished by way of central vein catheterization. We report the case of bleeding after withdrawal of the double lumen catheter. A 36-year-old woman who was a known case of end-stage renal disease referred to a dialysis center because of her arteriovenous fistula malfunction. A double-lumen catheter was inserted via the right internal jugular vein but failed to become functional so in the emergency department we decided to withdrawal catheter under cardiac monitoring and pulse oximetry but unfortunately A few minutes after the withdrawal of the double lumen Catheter the patient became agitated and confused. The resuscitation team after infusing IV fluid and blood decided to emergent thoracotomy. We control bleeding by direct pressure and repaired a rupture of the posterior aspect of the right internal jugular and right subclavian vein junction. Six hours later she became alert and one week after discharged, she was in well general condition.
血液透析需要可靠且可重复的进入体循环的通路,这可通过中心静脉置管来实现。我们报告一例双腔导管拔除后出血的病例。一名36岁女性,已知患有终末期肾病,因动静脉内瘘功能障碍转诊至透析中心。经右颈内静脉插入一根双腔导管,但未能发挥作用,因此在急诊科,我们决定在心脏监测和脉搏血氧饱和度监测下拔除导管,但不幸的是,双腔导管拔除几分钟后,患者变得烦躁不安且意识模糊。复苏团队在输注静脉液体和血液后决定紧急开胸手术。我们通过直接压迫控制出血,并修复了右颈内静脉与右锁骨下静脉交界处后侧的破裂处。6小时后她恢复清醒,出院一周后,她的一般状况良好。