Chang L Y, Horng Y C, Chou Y H, Tsou K I
Department of Pediatrics, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, ROC.
J Formos Med Assoc. 1995 Jun;94(6):355-7.
Cardiac tamponade occurs very rarely, but is life-threatening in the newborn. This paper reports a premature newborn who developed profound shock 25 hours after undergoing umbilical venous catheterization. Echocardiography taken later, showed marked pericardial effusion. An umbilical venous catheter was located in the left atrium. Immediate pericardiocentesis was performed, 11 mL of a clear straw-colored fluid was removed and the umbilical venous catheter was withdrawn into the inferior vena cava. The heart rate and blood pressure recovered immediately. Analysis of the pericardial fluid showed a high glucose level of 2,451 mg/dL. There was no pericardial effusion reaccumulation thereafter. Rapid diagnosis and treatment of pericardial effusion are mandatory to prevent subsequent morbidity and mortality when disastrous episodes, such as in the present case, occur.
心脏压塞在新生儿中极为罕见,但却危及生命。本文报告了一名早产新生儿,在接受脐静脉置管术后25小时出现严重休克。随后进行的超声心动图检查显示有明显的心包积液。一根脐静脉导管位于左心房。立即进行了心包穿刺,抽出了11毫升清澈的稻草色液体,并将脐静脉导管撤回至下腔静脉。心率和血压立即恢复。心包液分析显示葡萄糖水平高达2451毫克/分升。此后未再出现心包积液再积聚的情况。当发生如本病例这样的灾难性事件时,快速诊断和治疗心包积液对于预防后续的发病率和死亡率至关重要。