Hayden L, Stewart G R, Johnson D C, Fisher M M
Anaesth Intensive Care. 1981 Feb;9(1):53-7. doi: 10.1177/0310057X8100900109.
A man with severe peripheral vascular disease and requiring total parenteral nutrition because of short bowel syndrome was referred because a central venous catheter could not be inserted by conventional techniques. A right thoracotomy was performed and a Hickman catheter inserted via the right atrial appendage into the right atrium. This catheter was used for a total of seven months for total parenteral nutrition. For the last two months of this time, the patient was maintained at home on a Home Parenteral Nutrition Programme. After four months of total parenteral nutrition the patient developed recurrent fevers and the catheter was found to have migrated from the right atrium into the pulmonary artery. The catheter was resited under X-ray control and used for a further three months until the recurrence of fever and dyspnoea heralded the onset of septic pulmonary emboli resulting in his death.
一名患有严重外周血管疾病且因短肠综合征需要全胃肠外营养的男子前来就诊，原因是无法通过传统技术插入中心静脉导管。进行了右胸切开术，并通过右心耳将一根希克曼导管插入右心房。该导管总共用于全胃肠外营养七个月。在此期间的最后两个月，患者在家中接受家庭肠外营养计划维持治疗。全胃肠外营养四个月后，患者出现反复发热，发现导管已从右心房迁移至肺动脉。在X线控制下重新放置导管，并再使用了三个月，直到发热和呼吸困难复发预示着感染性肺栓塞的发生，最终导致患者死亡。
