Abstract:
:We present a case of fatal cardiac tamponade that occurred in association with a peripherally inserted central catheter (PICC) inserted from the right antecubital fossa. Migration of the catheter from the right atrium within 24 h of insertion lead to the administration of a potassium-enriched sodium chloride solution into the pericardial space with the development of ST-segment elevation and progression to pulseless electrical activity and, subsequently, ventricular fibrillation. Although signs of tamponade were seen on echocardiography, we propose that myocardial hyperkalaemia from the diffusion of potassium through the epicardium accounted for some of the clinical picture. PICC lines carry a greater risk of migration because of the tip movement associated with arm abduction and, therefore, care must be taken to ensure that the catheter tip is correctly positioned to reduce this risk. When such catheters are used for intra-operative central venous access, we believe chest radiography is mandatory before fluid administration through the catheter, but that this is unnecessary when the catheter is being used solely for central venous pressure monitoring. The use of softer catheters may reduce the risk of vessel perforation. Once tamponade is suspected, all drugs and infusions administered via the catheter should be reviewed, the catheter aspirated and echocardiography performed urgently. This may be facilitated by the greater availability of limited bedside echocardiography within critical care units and theatre complexes.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Orme RM,McSwiney MM,Chamberlain-Webber RFdoi
10.1093/bja/aem181subject
Has Abstractpub_date
2007-09-01 00:00:00pages
384-8issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34727-Xjournal_volume
99pub_type
杂志文章abstract:BACKGROUND:Pressure recording analytical method (PRAM) is a novel, arterial pulse contour-based method for measuring cardiac output (CO). Validation studies of PRAM in children are few, and have not assessed both absolute accuracy and ability to track changes in CO across a broad case mix. We aimed to compare CO as mea...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes420
更新日期:2013-03-01 00:00:00
abstract::To determine the influence of renal failure on the pharmacokinetics and neuromuscular blockade of Org NC 45 (Norcuron), a new monoquaternary homologue of pancuronium, 13 patients under halothane and nitrous oxide anesthesia were studied. Org NC 45 was administered by 2-min infusion in doses of 0.28 mg kg-1 (normal ren...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.10.1049
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:Dynamic arterial elastance (Eadyn) has been proposed as an indicator of vascular tone that predicts the decrease in arterial pressure in response to changes in norepinephrine (NE). The purpose of this study was to determine whether Eadyn measured by uncalibrated pulse contour analysis (UPCA) can predict a de...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.01.032
更新日期:2018-09-01 00:00:00
abstract::A new type of intra-arterial oxygen electrode was evaluated. In 14 patients, undergoing one-lung ventilation for thoracic surgery, the electrode was inserted into the radial artery and changes in PaO2 were recorded continuously. Methods of improving PaO2 during one-lung ventilation were demonstrated. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.10.1005
更新日期:1976-10-01 00:00:00
abstract::Day-case anaesthesia requires rapidly eliminated anaesthetics which are relatively expensive. This multinational, multicentre European study assessed the relative costs of propofol or sevoflurane anaesthesia in 211 patients. Anaesthesia was induced and maintained with propofol in group 1, with propofol and sevoflurane...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/83.4.564
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:There has been a renewed interest in nitric oxide donor drugs, such as nitroglycerin, delivered by the inhalational route for treatment of pulmonary arterial hypertension (PAH). We investigated the acute effects of inhaled nitroglycerin on pulmonary and systemic haemodynamics in children with PAH associated ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael112
更新日期:2006-08-01 00:00:00
abstract::In the prone knee-chest position the spread of plain 0.5% bupivacaine in the cerebrospinal fluid and associated haemodynamic changes may be different compared with the horizontal position. A randomized comparison was performed in 40 ASA I-II patients, aged 24-61 yr, undergoing lumbar disc surgery. Subarachnoid injecti...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/79.5.609
更新日期:1997-11-01 00:00:00
abstract::Following antagonism of tubocurarine block with a mixture of atropine 20 microgram/kg and neostigmine 50 microgram/kg in 20 children, heart rate decreased from a control value of 110.4 beat/min to 90.1 at 5 min and 89.2 at 6 min (P less than 0.02). Stroke volume index did not change during the first 5 min from a contr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.9.901
更新日期:1977-09-01 00:00:00
abstract:INTRODUCTION:Compared with term neonates, preterm babies are more likely to die from sepsis. However, the combined effects of sepsis and prematurity on neonatal postoperative mortality are largely unknown. Our objective was to quantify the proportion of neonatal postoperative mortality that is attributable to the syner...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.bja.2020.07.026
更新日期:2020-12-01 00:00:00
abstract::Nausea and vomiting occur commonly during and after Caesarean delivery (CD) performed under neuraxial anaesthesia. Metoclopramide is a prokinetic agent reported to be safe in parturients. This meta-analysis assesses the efficacy of metoclopramide for prophylaxis against intra- and postoperative nausea and vomiting (IO...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aer509
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The optimal dose of oxytocin at Caesarean section is unclear. Oxytocin may cause adverse cardiovascular effects, including tachycardia and hypotension, whereas an inadequate dose can result in increased uterine bleeding. We compared the effects of two doses of oxytocin in a randomized double-blind trial. ME...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen273
更新日期:2008-12-01 00:00:00
abstract::The induction dose requirements of propofol were compared in three age groups in 300 unpremedicated healthy Chinese children: group A, younger than 2 yr (n = 48); group B, 2-5 yr (n = 117); group C, 6-12 yr (n = 135). Patients in each group were allocated randomly to receive one of eight doses of propofol (1.2, 1.4, 1...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/68.1.64
更新日期:1992-01-01 00:00:00
abstract::Thirty-two patients received lumbar extradural anaesthesia for elective Caesarean section. The results obtained from this series were compared with those from a similar (control) group of parturients who received general anaesthesia. The extradural group (mothers and infants) were metabolically acidaemic relative to c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.4.367
更新日期:1979-04-01 00:00:00
abstract::We have studied the cardiovascular effects of equipotent concentrations of halothane or isoflurane, with or without 50% nitrous oxide in oxygen, in 80 patients, aged 60 yr or more, during 20 min of stable equipotent anaesthesia. Non-invasive measurement techniques were used, with suprasternal Doppler ultrasonography f...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/80.2.169
更新日期:1998-02-01 00:00:00
abstract::Mean venous pressures were measured in 20 patients in whom a catheter, inserted via the external jugular vein, failed to pass centrally. The catheter used had a rounded end and two side holes. Pressures were measured with the patient's head in three different positions. The pressures were compared with the central ven...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.12.1384
更新日期:1986-12-01 00:00:00
abstract::Isolated, cultured rat pancreatic islets of Langerhans were incubated in medium containing glucose 2 or 20 mmol litre-1 and with glucose supplemented with midazolam 10, 100 or 1000 ng ml-1. Glucose 20 mmol litre-1 with the addition of noradrenaline 10 mumol litre-1 was used as a control. In contrast with noradrenaline...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/70.2.221
更新日期:1993-02-01 00:00:00
abstract::On accout of its histamine releasing and ganglion blocking properties tubocurarine is known to have significant haemodynamic effects. Methylation of the compound produces metocurine and should decrease both histamine release and ganglionic blockade. The haemodynamic effects of these two compounds were compared in 10 m...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.11.1007
更新日期:1979-11-01 00:00:00
abstract:BACKGROUND:Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS:This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 53...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev373
更新日期:2016-01-01 00:00:00
abstract::Two techniques for endotracheal anaesthesia in dental outpatients have been compared: a spontaneous ventilation technique using nitrous oxide, oxygen and halothane, and a controlled ventilation technique using nitrous oxide and oxygen, with tubocurarine and fentanyl. The latter technique has several advantages: abolit...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/48.9.919
更新日期:1976-09-01 00:00:00
abstract::The effects of diazepam, which acts at GABAA receptors to enhance the effects of GABA, and ketamine, a non-competitive N-methyl-D-aspartate receptor antagonist, on local rates of cerebral glucose utilization (ICMRglc) were examined in unrestrained rats. Four groups were studied: vehicle-injected controls; and ketamine...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/82.4.596
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Signalling of several G-protein-coupled receptors of the Gq/11 family is time-dependently inhibited by local anaesthetics (LAs). Since LA-induced modulation of muscarinic m1 and m3 receptor function may explain their beneficial effects in clinical practice, such as decreased postoperative cognitive dysfuncti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet299
更新日期:2014-02-01 00:00:00
abstract::We have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients rece...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/83.5.813
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Propofol is used during living-related donor liver transplantation because its metabolism is not greatly affected by liver failure. However, the pharmacokinetics of propofol during liver transplantation have not been fully defined. The purpose of this study was to evaluate the apparent systemic clearance of ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei243
更新日期:2005-11-01 00:00:00
abstract::The trachea of a man who had cut his own throat was successfully intubated using a fibreoptic laryngoscope after attempts at conventional oral intubation had failed. The advantages of the fibreoptic instrument and the method of use in such an injury are discussed. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.5.511
更新日期:1978-05-01 00:00:00
abstract:BACKGROUND:Lidocaine is frequently used as an agent to treat ventricular arrhythmias associated with acute myocardial ischaemia. Lidocaine is a potent blocker not only of sodium channels, but also of ATP-sensitive potassium channels. The opening of these channels is a key mechanism of ischaemic preconditioning. We inve...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh262
更新日期:2004-11-01 00:00:00
abstract::We evaluated prospectively the use of Gram staining of protected pulmonary specimens to allow the early diagnosis of ventilator-associated pneumonia (VAP), compared with the use of 60 bronchoscopic protected specimen brushes (PSB) and 126 blinded plugged telescopic catheters (PTC) obtained from 134 patients. Gram stai...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.5.735
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:The oesophageal leak pressure is defined as the pressure which breaks the seal between the cuff of a supraglottic airway and the peri-cuff mucosa, allowing penetration of fluid into the pharynx and the oral cavity. As a consequence, a decrease in this variable increases the risk of reflux and can lead to pul...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev435
更新日期:2016-02-01 00:00:00
abstract::To assess the usefulness of the Gram stain in the early diagnosis of ventilator-associated pneumonia (VAP), we performed 146 protected specimen brushings (PSB) and bronchoalveolar lavages (BAL) in 118 patients suspected of having nosocomial pneumonia. Gram stain and counts of infected cells were performed in all sampl...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.845
更新日期:1999-12-01 00:00:00
abstract::We have used the technique of double-blind sequential allocation to quantify the minimum local analgesic concentration (MLAC) of extradural bupivacaine for women in early (median cervical dilatation 2 cm) and late (median cervical dilatation 5 cm) labour. The first bolus was 20 ml of the bupivacaine test solution. The...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/80.1.11
更新日期:1998-01-01 00:00:00
abstract::One hundred and one patients with osteoarthritis were randomly allocated to undergo total hip arthroplasty under either spinal (subarachnoid) or general anaesthesia. Venous blood was sampled before, during and after surgery and on the 5th day after operation to study the haemostatic mechanism. There were no preoperati...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/59.5.561
更新日期:1987-05-01 00:00:00