Rutherford J S, Merry A F, Occleshaw C J
Green Lane Hospital, Auckland, New Zealand.
Anaesth Intensive Care. 1994 Jun;22(3):267-71. doi: 10.1177/0310057X9402200303.
Central venous catheter (CVC) depth relative to the cephalic limit of the pericardial reflection (CLPR) was assessed retrospectively in 100 adult patients from chest radiographs taken after admission to the intensive care unit. A well known landmark proved to be considerably influenced by parallax; therefore we located the CLPR by a new landmark, the junction of the azygos vein and the superior vena cava, identified by the angle of the right main bronchus and the trachea. The majority (58) of CVC tips lay below the pericardial reflection on the first chest radiograph (CXR). Of these only two had been corrected by the time of the next routine CXR. No case of cardiac tamponade secondary to erosion by a CVC could be remembered, or identified from records of routine departmental audit meetings, for the last ten years. Nevertheless, reported incidents of this complication have often been fatal and vigilance is necessary in any patient with a CVC.
对100例成年患者入住重症监护病房后拍摄的胸部X光片进行回顾性分析，评估中心静脉导管（CVC）相对于心包反折头侧界限（CLPR）的深度。一个广为人知的标志点受视差影响很大；因此，我们通过一个新的标志点来定位CLPR，即奇静脉与上腔静脉的交界处，由右主支气管与气管的夹角确定。在第一张胸部X光片（CXR）上，大多数（58例）CVC尖端位于心包反折下方。其中只有两例在下一次常规CXR时得到纠正。在过去十年中，没有因CVC侵蚀导致心包填塞的病例被记住，也未从常规科室审核会议记录中发现此类病例。然而，报道的这种并发症事件往往是致命的，对任何置有CVC的患者都必须保持警惕。
