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小儿患者 Hickman 导管置入术后并发血胸:早期识别与处理的病例报告

Hemothorax Complicating Hickman Line Placement in a Pediatric Patient: A Case Report of Early Recognition and Management.

作者信息

Ayaz Feras, Arafah Osamah, Aljonaieh Khalid, Al Mallohi Norah, Alshibi Leen

机构信息

Anesthesia, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.

出版信息

Cureus. 2025 Feb 20;17(2):e79344. doi: 10.7759/cureus.79344. eCollection 2025 Feb.

Abstract

Central venous catheters (CVCs) are essential in managing pediatric patients requiring long-term venous access, particularly for bone marrow transplantation (BMT). Although generally safe, their insertion is not without risks. We report the case of a one-year-old boy with Severe Combined Immunodeficiency Disorder (SCID) who developed a life-threatening right-sided hemothorax during Hickman line placement. The patient presented with acute hemodynamic instability and pulseless electrical activity (PEA) following multiple failed cannulation attempts. Immediate resuscitation measures restored circulation, and imaging revealed a large hemothorax. A chest tube was inserted, draining 138 mL of blood, leading to clinical stabilization. This case highlights the importance of early complication recognition, imaging, and prompt intervention during central venous catheterization.

摘要

中心静脉导管(CVCs)对于管理需要长期静脉通路的儿科患者至关重要,尤其是在骨髓移植(BMT)中。尽管通常是安全的,但插入过程并非没有风险。我们报告了一例一岁患有严重联合免疫缺陷病(SCID)的男孩,在放置Hickman导管期间发生了危及生命的右侧血胸。在多次插管尝试失败后,患者出现急性血流动力学不稳定和无脉电活动(PEA)。立即采取复苏措施恢复了循环,影像学检查显示有大量血胸。插入了胸管,引出138毫升血液,使临床情况稳定下来。该病例强调了在中心静脉置管过程中早期识别并发症、进行影像学检查和及时干预的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89c2/11929028/bc066eafad68/cureus-0017-00000079344-i01.jpg

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