Cui Yu, Liu Kai, Luan Liming, Liang Peng
Department of Anesthesiology, Chengdu Women's and Children's Central Hospital, Chengdu 610091, Sichuan Province, China.
Department of Anesthesiology, Vanderbilt Medical Center, Nashville, TN 37232-5614, United States.
World J Clin Cases. 2021 Jan 26;9(3):602-606. doi: 10.12998/wjcc.v9.i3.602.
Peripherally inserted central catheters (PICCs) have been increasingly applied worldwide owing to many advantages. Even with these advantages, the related complications should not be ignored, especially in neonates. The available evidence about PICC-related thrombosis was manifold, but the cardiac tamponade, an emergency and life-threatening complication, has been rarely reported. Early recognized cardiac tamponade by ultrasound may reduce mortality.
A neonate weighting 2.8 kg was born at 40 wk of gestation. He was admitted to the Surgery Intensive Care Unit due to suspected congenital megacolon. A PICC line was inserted via the left antecubital fossa for the administration of total parenteral nutrition. Three days later, the patient was still on total parenteral nutrition. Cardiac tamponade caused by PICC was found on ultrasound. The patient recovered spontaneously after an emergency pericardiocentesis.
Proficiency in the use of point-of-care ultrasound may save the life of patients, since it enables clinicians to treat patients faster, more accurately, and in a non-invasive way at the point of care.
由于诸多优点，外周静脉穿刺中心静脉导管（PICC）在全球范围内的应用日益广泛。即便有这些优点，相关并发症也不容忽视，尤其是在新生儿中。关于PICC相关血栓形成的现有证据众多，但心脏压塞这种紧急且危及生命的并发症却鲜有报道。超声早期识别心脏压塞可能降低死亡率。
一名体重2.8千克的新生儿在妊娠40周时出生。因疑似先天性巨结肠入住外科重症监护病房。经左肘前窝插入一根PICC导管用于全胃肠外营养。三天后，患者仍在接受全胃肠外营养。超声检查发现由PICC导致的心脏压塞。紧急心包穿刺术后患者自行康复。
熟练使用床旁超声可能挽救患者生命，因为它能让临床医生在床旁更快、更准确且以非侵入性方式治疗患者。
