Cherng Y G, Cheng Y J, Chen T G, Wang C M, Liu C C
Department of Anaesthesiology, National Taiwan University Hospital, Taipei.
Anaesthesia. 1994 Dec;49(12):1052-4. doi: 10.1111/j.1365-2044.1994.tb04354.x.
A 2994 g infant suffered cardiac tamponade from an infusion of total parenteral nutrition through an indwelling central venous catheter. The infant survived as a result of early diagnosis and aggressive therapeutic intervention. Cardiac tamponade secondary to central venous catheterisation is rare, but potentially lethal. Possible mechanisms are direct puncture by the catheter tip, or osmotic injury from the use of hypertonic solutions. To avoid this complication, the catheter tip should be prevented from entering the right atrium and its position should be checked periodically by chest X ray. Cardiac tamponade should be considered in any patient with a central venous catheter whose clinical condition deteriorates suddenly. Diagnostic or therapeutic pericardiocentesis should be employed as the first measure and time should not be wasted on other diagnostic procedures.
一名体重2994克的婴儿通过留置中心静脉导管输注全胃肠外营养时发生了心脏压塞。由于早期诊断和积极的治疗干预，该婴儿存活下来。中心静脉置管继发的心脏压塞很少见，但可能致命。可能的机制是导管尖端直接穿刺，或使用高渗溶液导致的渗透性损伤。为避免这种并发症，应防止导管尖端进入右心房，并定期通过胸部X线检查其位置。任何使用中心静脉导管的患者，若临床状况突然恶化，都应考虑心脏压塞。应将诊断性或治疗性心包穿刺作为首要措施，不应在其他诊断程序上浪费时间。
