Abstract
Cardiac arrhythmias during central venous catheter (CVC) insertion are typically transient
events with no hemodynamic repercussions. Pediatric reports on this condition are
scarce and fail to describe potentially life-threatening complications.
Case
A 14-day-old boy was admitted to the pediatric intensive care unit presenting with
septic shock. During CVC insertion, the patient developed supraventricular tachycardia
(SVT), which was unresponsive to vagal maneuvers or adenosine. Chest roentgenogram
control revealed the tip of the catheter positioned in the midportion of the superior
vena cava. After 30 minutes, the patient had a heart rate of 215 beats/min (bpm) and
signs of hemodynamic compromise. The SVT eventually reverted to a sinus rhythm with
synchronized cardioversion. The patient was discharged in good health.
Conclusion
Awareness of this potential complication of CVC insertion warrants a high level of
concern by pediatric surgeons performing these procedures. Patients with sepsis and/or
cardiac dysfunction who present SVT during catheter insertion can represent a therapeutic
challenge for surgeons.
Key words
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Article info
Publication history
Accepted:
May 10,
2010
Received in revised form:
May 7,
2010
Received:
March 6,
2010
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
