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全身麻醉下与外周中心静脉导管尾端移位相关的体位改变诱发心律失常：一例报告

Arrhythmia Induced by Positional Change Under General Anesthesia Related to Caudal Movement of the Peripherally Inserted Central Venous Catheter: A Case Report.

作者信息

Utsumi Isao, Hascilowicz Tomasz, Mio Yasushi, Omi Sachiko

机构信息

Department of Anesthesiology, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Case Rep Anesthesiol. 2024 Dec 27;2024:9185758. doi: 10.1155/cria/9185758. eCollection 2024.

DOI:10.1155/cria/9185758
PMID:39760114
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11698605/
Abstract

The novel case report of a temporary arrhythmia that developed after a positional change in a patient under general anesthesia emphasizes the possibility of potentially lethal cardiac arrhythmias that may develop owing to caudal movement of the peripherally inserted central venous catheter ([CVC] PICC) tip when changing patient positions. We present a case of temporary arrhythmia that developed after a positional change in a 44-year-old female patient scheduled for laparoscopic adrenalectomy under general anesthesia. She had undergone preoperative insertion of a PICC using an electrocardiogram (ECG)-guided tip confirmation system (TCS). The case report discusses the optimal TCS and emphasizes vigilant ECG monitoring, suggesting measures to prevent these arrhythmias under general anesthesia.

摘要

这篇关于一名在全身麻醉下改变体位后出现暂时性心律失常的新型病例报告强调了以下可能性

在改变患者体位时，外周静脉中心静脉导管（[CVC] PICC）尖端的尾端移动可能会引发潜在致命性心律失常。我们报告了一例44岁女性患者的病例，该患者在全身麻醉下计划进行腹腔镜肾上腺切除术，改变体位后出现了暂时性心律失常。她术前使用了心电图（ECG）引导的尖端确认系统（TCS）插入了PICC。该病例报告讨论了最佳的TCS，并强调了警惕性的心电图监测，提出了在全身麻醉下预防这些心律失常的措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7d/11698605/989e7817143f/CRIA2024-9185758.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7d/11698605/0c295fc875c0/CRIA2024-9185758.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7d/11698605/f8fb0417cfe4/CRIA2024-9185758.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7d/11698605/989e7817143f/CRIA2024-9185758.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7d/11698605/0c295fc875c0/CRIA2024-9185758.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7d/11698605/f8fb0417cfe4/CRIA2024-9185758.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7d/11698605/989e7817143f/CRIA2024-9185758.003.jpg

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本文引用的文献

1
Practical guide for safe central venous catheterization and management 2017.《2017年安全中心静脉置管与管理实用指南》
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Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study.住院患者和门诊患者使用外周静脉穿刺中心静脉导管（PICC）的并发症：一项前瞻性队列研究。
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中心静脉置管时三种导丝插入深度对心律失常发生率影响的随机对照研究
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Position-Dependent Ventricular Tachycardia Related to Peripherally Inserted Central Venous Catheter.与外周置入中心静脉导管相关的位置依赖性室性心动过速
Methodist Debakey Cardiovasc J. 2016 Sep;12(3):177-178. doi: 10.14797/mdcj-12-3-177.
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Anaesthesia. 2016 May;71(5):573-85. doi: 10.1111/anae.13360. Epub 2016 Feb 17.
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Sherlock 3CG(®) Tip Confirmation System for Placement of Peripherally Inserted Central Catheters: A NICE Medical Technology Guidance.用于外周静脉穿刺中心静脉导管置管的Sherlock 3CG(®)尖端确认系统：英国国家卫生与临床优化研究所医疗技术指南
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Evaluation of the Sherlock 3CG Tip Confirmation System on peripherally inserted central catheter malposition rates.评估 Sherlock 3CG 尖端确认系统在外周置入中心静脉导管（PICC）导管尖端异位率中的作用。
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ESPEN Guidelines on Parenteral Nutrition: central venous catheters (access, care, diagnosis and therapy of complications).欧洲临床营养与代谢学会肠外营养指南：中心静脉导管（置入、护理、并发症的诊断与治疗）
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