因插入Swan-Ganz导管导致原有中心静脉导管二次移位——病例报告
Secondary migration of a pre-existing central venous catheter due to a Swan-Ganz catheter insertion - A case report.
作者信息
Cho Joonho, Yoo Byung Hoon, Park Jihwan, Lim Yun Hee, Jun In-Jung, Kim Kye-Min
机构信息
Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
出版信息
Anesth Pain Med (Seoul). 2023 Jan;18(1):46-50. doi: 10.17085/apm.22212. Epub 2023 Jan 10.
BACKGROUND
The entanglement of multiple central venous catheters is a rare and seriouscomplication. The Swan-Ganz catheter is a responsible for various cases.
CASE
A 66-year-old male patient was under general anesthesia for a coronary artery bypassgraft surgery. As he had a pre-existing Perm catheter in the right subclavian vein, a SwanGanz catheter was inserted into the left internal jugular vein. Chest radiograph after catheterplacement revealed that the Perm catheter had migrated to the left brachiocephalic vein.The surgeon attempted to reposition it manually, but postoperative radiograph showed thatit had rolled into a loop. On postoperative day 1, radiological intervention was performed tountangle the loop, which was successful.
CONCLUSIONS
After placing a Swan-Ganz catheter in patients with a pre-existing central venous catheter, the presence of entanglement should be assessed. In such cases, radiology-guided correction is recommended, as a blind attempt to disentangle can aggravate thecondition.
背景
多条中心静脉导管缠结是一种罕见且严重的并发症。Swan-Ganz导管是多种此类情况的诱因。
病例
一名66岁男性患者在全身麻醉下接受冠状动脉搭桥手术。由于其右锁骨下静脉已留置Perm导管，故将Swan-Ganz导管插入左颈内静脉。置管后胸部X线片显示Perm导管已迁移至左头臂静脉。外科医生试图手动重新放置，但术后X线片显示其已卷成一个环。术后第1天，进行了放射介入以解开该环，手术成功。
结论
在已有中心静脉导管的患者中置入Swan-Ganz导管后，应评估是否存在缠结。在此类情况下，建议进行放射学引导下的纠正，因为盲目尝试解开可能会使情况恶化。
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