Akingbola O A, Nielsen J, Hopkins R L, Frieberg E M
Tulane School of Medicine, New Orleans, Louisiana, USA.
Crit Care. 2000;4(2):120-3. doi: 10.1186/cc666. Epub 2000 Mar 3.
The femoral vein is an important site for central venous access in newborns and infants. The objectives of this study are to determine whether age or weight can be used clinically to predict the size of the femoral vein in newborns and infants, and to compare the size of the vein in each individual in both the supine and reverse Trendelenburg positions.
Analysis was done in 24 euvolemic individuals, each studied in both the supine and reverse Trendelenburg positions. Twelve of these individuals were newborns and 12 were infants. We used two-factor analysis of variance to explore differences between groups and multiple linear regression analysis to estimate the strength of the relationship between variables. In the infant group, there was a correlation between femoral vein diameter and weight. There was no correlation between weight and vessel size in newborns. In both the newborn and infant groups, vessel diameter increased with subjects in the reverse Trendelenburg position (P < 0.01).
Weight is predictive of femoral vein diameter in infants, but not in newborns. In infants, weight might serve as a more sensitive index for estimating size of the femoral vein in order to determine accurately the size of intravascular catheter appropriate for cannulation. The diameter of the femoral vein increases in the reverse Trendelenburg position compared with that in the supine position in both newborns and infants. A large prospective study is required to validate these findings.
股静脉是新生儿和婴儿中心静脉置管的重要部位。本研究的目的是确定年龄或体重是否可在临床上用于预测新生儿和婴儿股静脉的大小,并比较每个个体在仰卧位和头低脚高位时静脉的大小。
对24名血容量正常的个体进行了分析,每个个体均在仰卧位和头低脚高位进行研究。其中12名个体为新生儿,12名个体为婴儿。我们使用双因素方差分析来探讨组间差异,并使用多元线性回归分析来估计变量之间关系的强度。在婴儿组中,股静脉直径与体重之间存在相关性。新生儿体重与血管大小之间无相关性。在新生儿和婴儿组中,头低脚高位时血管直径均增加(P < 0.01)。
体重可预测婴儿的股静脉直径,但不能预测新生儿的股静脉直径。在婴儿中,体重可能是估计股静脉大小的更敏感指标,以便准确确定适合置管的血管内导管尺寸。与仰卧位相比,新生儿和婴儿在头低脚高位时股静脉直径均增加。需要进行大规模前瞻性研究来验证这些发现。