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一名患有腹裂的婴儿因外周中心静脉导管引发室上性心动过速。

Supraventricular tachycardia precipitated by a peripherally inserted central catheter in an infant with gastroschisis.

作者信息

Thyoka Mandela, Haq Iram, Hosie Gareth

机构信息

Surgery Unit, UCL Institute of Child Health, London, UK.

出版信息

BMJ Case Rep. 2014 Feb 25;2014:bcr2013201203. doi: 10.1136/bcr-2013-201203.

Abstract

Gastroschisis is a common congenital abdominal wall defect requiring surgical correction in early neonatal life. The time to full enteral feeds among infants with gastroschisis is variable. Gastroschisis remains a common surgical cause of intestinal failure in neonates. Peripherally inserted central catheters (PICC) are commonly used to provide long-term venous access for parenteral nutrition during the time enteral feeds are being slowly established. The PICC is placed under fluoroscopic guidance with the distal end of the catheter usually placed at the junction of the superior vena cava with the right atrium. In rare circumstances, the catheter tip may advance into intracardiac chambers, precipitating supraventricular re-entrant tachycardia. We report a case of an infant who was antenatally diagnosed with uncomplicated gastroschisis in whom a supraventricular tachycardia was precipitated by the PICC in the right atrium.

摘要

腹裂是一种常见的先天性腹壁缺损,需要在新生儿早期进行手术矫正。腹裂婴儿完全经口喂养的时间各不相同。腹裂仍然是新生儿肠道衰竭常见的手术原因。在逐渐建立经口喂养期间,外周静脉穿刺中心静脉导管(PICC)常用于为肠外营养提供长期静脉通路。PICC在荧光透视引导下放置,导管远端通常置于上腔静脉与右心房交界处。在极少数情况下,导管尖端可能进入心腔内,引发室上性折返性心动过速。我们报告一例产前诊断为单纯性腹裂的婴儿,其右心房内的PICC引发了室上性心动过速。

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Central venous catheter tip position: a continuing controversy.中心静脉导管尖端位置:持续存在的争议。
J Vasc Interv Radiol. 2003 May;14(5):527-34. doi: 10.1097/01.rvi.0000071097.76348.72.
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Complications of intra-cardial placement of silastic central venous catheter in pediatric patients.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1996 Nov-Dec;37(6):410-4.

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