Byeon Gyeong-Jo, Kim Eun-Jung, Yoon Ji-Young, Yoon Seok-Hyun, Woo Mi-Na, Kim Cheul-Hong
Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Korea.
Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Korea.
J Dent Anesth Pain Med. 2015 Mar;15(1):31-34. doi: 10.17245/jdapm.2015.15.1.31. Epub 2015 Mar 31.
Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.
据报道，中心静脉导管（CVC）引起的血管损伤是一种罕见的并发症，尤其是CVC导致的延迟性血管损伤病例较少，且由于识别延迟和更严重的并发症，可能会致命。一名59岁无既往病史的女性因卵巢癌入院治疗。手术时，通过左锁骨下静脉置入了一根三腔CVC。术后第一天通过CVC进行肠外营养以进行术后营养管理。术后第六天（POD），患者突然出现呼吸困难。CT显示双侧胸腔积液，前纵隔有不规则软组织密度影和气泡，提示CVC远端部分移入前纵隔。在重症监护病房（ICU）进行了双侧胸腔穿刺和经皮引流。3天后她从ICU出院并转入普通病房。该病例强调了与CVC相关的延迟性血管损伤的可能性以及一些预防血管损伤的策略。
