- 期刊
Pneumomediastinum Complicated by Subclavian Central Venous Catheterization in a Severe Thoracic Trauma Patient
嚴重胸部外傷病患施行鎖骨刺下靜脈中心導管植入引起之縱隔腔氣腫
摘要
鎖骨下靜脈中心導管植入而引起之縱膈腔氣腫，在臨床上是個罕見的併發症。對於胸部外傷，合併有雙側血氣胸及使用高吐氣末正壓呼吸的病患，我們不僅須要明瞭在如此之高風險情況下所可能衍生的併發症，為了有助於施行鎖骨下靜脈中心導管植入，更必須將呼吸器調整為更低之吐氣末正壓及更低之潮氣容積，甚至短暫終止呼吸器的使用。
並列摘要
Pneumomediastinum is a rare event in subclavian central venous catheterization. However in severe thoracotraumatized patients, such as with bilateral hemopneumothorax, the catherization may be hazardous and made complex by occurrence pneumomediastinum, even the procedure is rightly carried out. We suggest that in such a risky condition, if it is mandatory, it should be carried out in a more placid condition, such as avoidance of high PEEP ventilation, setting lower tidal volume, or brief interruption of positive ventilation, to reduce the likelihood of unperceivable pneumomediastinum.
延伸閱讀
- Chen, W. Y., Lin, J. A., Chen, H. L., Wong, C. S., Ho, S. T., & Lu, C. C. (2004). 於麻醉誘導時使用Fastrach插管式喉頭罩和換管通條引導插管導致氣胸之病例報告. Acta Anaesthesiologica Taiwanica, 42(4), 227-231. https://www.airitilibrary.com/Article/Detail?DocID=02541319-200412-42-4-227-231-a
- Wu, Y. C., Chen, C. L., Lin, I. L., & Chung, Y. T. (2005). 鎖骨下腋靜脈置入中央靜脈導管引發氣胸－病例報告. Acta Anaesthesiologica Taiwanica, 43(2), 105-108. https://www.airitilibrary.com/Article/Detail?DocID=02541319-200506-43-2-105-108-a
- Hsu, C. W., Hsiao, H. F., & Mo, H. H. (2012). 鎖骨下中心靜脈導管置放術的罕見併發症：肺動脈穿刺. 輔仁醫學期刊, 10(4), 211-216. https://www.airitilibrary.com/Article/Detail?DocID=18102093-201212-201304120011-201304120011-211-216
- Hung, W. T., Hsiao, P. N., & Chen, K. C. (2019). 以免插管胸腔鏡肺泡切除術及肋膜沾黏術治療一名氣胸之裘馨氏肌肉失養症病人：病例報告. 胸腔醫學, 34(4), 148-154. https://www.airitilibrary.com/Article/Detail?DocID=10239855-201908-201907290010-201907290010-148-154
- Yau, W. H., Fong, Y., Lin, C. N., & Shieh, J. M. (2012). 肺動靜脈畸形仿似孤立性肺結節，CT引導下細針穿刺切片可能引起致命的併發症：一病例報告. 胸腔醫學, 27(2), 88-93. https://doi.org/10.29806/TM.201204.0003