Amer Aya, Broadbent Roland S, Edmonds Liza, Wheeler Benjamin J
Department of Women's and Children's Health, University of Otago, Dunedin School of Medicine, P.O. Box 56, Dunedin 9054, New Zealand.
Case Rep Med. 2016;2016:6206358. doi: 10.1155/2016/6206358. Epub 2016 Dec 12.
Central venous access is an important aspect of neonatal intensive care management. Malpositioned central catheters have been reported to induce cardiac tachyarrhythmia in adult populations and there are case reports within the neonatal population. We present a case of a preterm neonate with a preexisting umbilical venous catheter (UVC), who then developed a supraventricular tachycardia (SVT). This was initially treated with intravenous adenosine with transient reversion. Catheter migration was subsequently detected, with the UVC tip located within the heart. Upon withdrawal of the UVC and a final dose of adenosine, the arrhythmia permanently resolved. Our literature review confirms that tachyarrhythmia is a rare but recognised neonatal complication of malpositioned central venous catheters. We recommend the immediate investigation of central catheter position when managing neonatal tachyarrhythmia, as catheter repositioning is an essential aspect of management.
中心静脉通路是新生儿重症监护管理的一个重要方面。据报道,中心静脉导管位置不当会在成人中诱发心脏快速性心律失常,在新生儿群体中也有病例报告。我们报告一例患有脐静脉导管(UVC)的早产儿,随后发生了室上性心动过速(SVT)。最初用静脉注射腺苷进行治疗,出现短暂复律。随后检测到导管移位,UVC尖端位于心脏内。拔出UVC并给予最后一剂腺苷后,心律失常永久消失。我们的文献综述证实,快速性心律失常是中心静脉导管位置不当导致的一种罕见但已被认识到的新生儿并发症。我们建议在处理新生儿快速性心律失常时立即检查中心导管位置,因为导管重新定位是管理的一个重要方面。