Gapp Jonathan, Krishnan Mridula, Ratnaraj Felicia, Schroell Robert P, Moore Douglas
Internal Medicine, Creighton University Medical Center.
Pulmonary, Critical Care and Sleep Medicine, Creighton University Medical Center.
Cureus. 2017 Jun 3;9(6):e1308. doi: 10.7759/cureus.1308.
We present two cases of patients being treated for diabetic ketoacidosis in the intensive care unit who experienced cardiac arrhythmia secondary to peripherally inserted central catheters (PICCs). In one instance, the patient became bradycardic and experienced related loss of consciousness, ultimately requiring cardiopulmonary resuscitation. In the second case, the patient experienced an episode of nonsustained ventricular tachycardia. We explore the various types of arrhythmias that have been reported secondary to central venous catheters, as well as factors that place patients at an increased risk for arrhythmia while undergoing PICC insertion. Furthermore, we look at the literature for methods to improve the insertion of PICC lines by decreasing the risk of catheter over-insertion as well as the effects of training for PICC placement.
我们报告了两例在重症监护病房接受糖尿病酮症酸中毒治疗的患者,他们因外周静脉穿刺中心静脉导管(PICC)继发心律失常。其中一例患者出现心动过缓并伴有相关意识丧失,最终需要进行心肺复苏。在第二例中,患者经历了一次非持续性室性心动过速发作。我们探讨了已报道的继发于中心静脉导管的各种心律失常类型,以及在进行PICC置管时使患者心律失常风险增加的因素。此外,我们查阅文献,寻找通过降低导管过度置入风险来改善PICC置管的方法,以及PICC置管培训的效果。