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锁骨下静脉置管及中心静脉导管放置过程中并发意外直接肺动脉插管:一例病例报告及文献复习

Inadvertent direct pulmonary artery catheterization complicating the effort for subclavian venous cannulation and central venous catheter placement: A case report and review of the literature.

作者信息

Papamichalis Panagiotis, Alexiou Evangelos, Zafeiridis Tilemachos, Neou Evangelia, Katsiafylloudis Periklis, Karagiannis Spyridon, Papadopoulos Dimitrios, Mourkas Vasileios, Skoura Apostolia-Lemonia, Komnos George, Papamichalis Michail, Komnos Apostolos

机构信息

Intensive Care Unit, General Hospital of Larissa, Larissa, Greece.

Department of Radiology, General Hospital of Larissa, Larissa, Greece.

出版信息

Int J Crit Illn Inj Sci. 2020 Jul-Sep;10(3):143-147. doi: 10.4103/IJCIIS.IJCIIS_94_19. Epub 2020 Sep 22.

Abstract

Subclavian access is commonly used in the intensive care unit (ICU) for central venous catheterization. Many complications have been reported during the placement of central venous catheters including pneumothorax, hemothorax, hematoma, and bleeding. The direct, through the thoracic wall, catheterization of pulmonary artery is a very rare one with only three previous reports in the literature. We report a patient who was catheterized for subclavian venous catheter placement, but the imaging techniques (chest X-ray and computed tomography with reconstruction of the images) revealed the direct positioning of the catheter into the pulmonary trunk, fortunately without other adverse events for the patient. Our case report in accordance with recent review of the literature strongly emphasizes the benefits of performing ultrasound-guided interventions in ICU.

摘要

锁骨下静脉穿刺常用于重症监护病房(ICU)进行中心静脉置管。在放置中心静脉导管过程中已报道了许多并发症,包括气胸、血胸、血肿和出血。经胸壁直接进行肺动脉置管非常罕见,文献中仅有三篇既往报道。我们报告一例患者,其进行锁骨下静脉导管置管时,影像学检查(胸部X线和图像重建的计算机断层扫描)显示导管直接进入了肺动脉主干,幸运的是患者未出现其他不良事件。我们的病例报告结合近期文献综述强烈强调了在ICU进行超声引导下干预的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e017/7771621/ac36e1c5df0f/IJCIIS-10-143-g001.jpg

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