de Almeida Marcos Moura, Tavares Wládia Gislaynne de Sousa, Furtado Maria Mônica Alencar Araripe, Fontenele Maria Marcia Farias Trajano
Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará (UFC), Fortaleza, Ceará, Brasil.
Maternidade Escola Assis Chateaubriand, Universidade Federal do Ceará (UFC), Fortaleza, Ceará, Brasil.
Rev Paul Pediatr. 2016 Jan-Mar;34(1):132-5. doi: 10.1016/j.rpped.2015.05.005. Epub 2015 Oct 9.
: To describe a case of neonatal atrial flutter after the insertion of an intracardiac umbilical venous catheter, reporting the clinical presentation and reviewing the literature on this subject.
: A late-preterm newborn, born at 35 weeks of gestational age to a diabetic mother and large for gestational age, with respiratory distress and rule-out sepsis, required an umbilical venous access. After the insertion of the umbilical venous catheter, the patient presented with tachycardia. Chest radiography showed that the catheter was placed in the position that corresponds to the left atrium, and traction was applied. The patient persisted with tachycardia, and an electrocardiogram showed atrial flutter. As the patient was hemodynamically unstable, electric cardioversion was successfully applied.
: The association between atrial arrhythmias and misplaced umbilical catheters has been described in the literature, but in this case, it is noteworthy that the patient was an infant born to a diabetic mother, which consists in another risk factor for heart arrhythmias. Isolated atrial flutter is a rare tachyarrhythmia in the neonatal period and its identification is essential to establish early treatment and prevent systemic complications and even death.
描述1例心内脐静脉导管插入术后新生儿房扑病例，报告临床表现并复习该主题的相关文献。
一名晚期早产儿，孕35周出生，母亲为糖尿病患者，出生体重高于孕周，有呼吸窘迫且排除败血症，需要脐静脉通路。脐静脉导管插入后，患者出现心动过速。胸部X线检查显示导管置于对应左心房的位置，并进行了牵引。患者持续心动过速，心电图显示为房扑。由于患者血流动力学不稳定，成功实施了电复律。
文献中已描述了房性心律失常与脐导管位置不当之间的关联，但在本病例中，值得注意的是患者为糖尿病母亲所生婴儿，这是心律失常的另一个危险因素。孤立性房扑在新生儿期是一种罕见的快速心律失常，其识别对于早期治疗及预防全身并发症甚至死亡至关重要。
