Schönermarck U, Bosch T
Nephrology Division, Department I of Internal Medicine, University Hospital Munich-Grosshadern, Munich, Germany.
Ther Apher Dial. 2003 Apr;7(2):215-20. doi: 10.1046/j.1526-0968.2003.00039.x.
In the intensive care unit, apheresis therapy (including plasma exchange, selective immunoadsorption and -affinity and detoxification by hemoperfusion) is limited to certain disease entities. Temporary insertion of large-bore central venous catheters is necessary for efficient performance of apheresis therapy. The choice of the optimal catheter insertion site (femoral, subclavian or internal jugular vein route) depends on the individual situation, the experience of the operator and the anticipated treatment period. Morbidity and mortality of the patients concerned can be substantially increased by insertion and use of central venous catheters. Early and delayed complications are briefly discussed. Appropriate selection of the catheter insertion site, the catheter type, strictly aseptic insertion procedures and optimal care of catheter and insertion site are essential to avoid complications.
在重症监护病房，单采治疗（包括血浆置换、选择性免疫吸附、亲和吸附以及血液灌流解毒）仅限于某些疾病实体。为有效进行单采治疗，需要临时插入大口径中心静脉导管。最佳导管插入部位（股静脉、锁骨下静脉或颈内静脉途径）的选择取决于个体情况、操作者的经验以及预期的治疗周期。中心静脉导管的插入和使用会显著增加相关患者的发病率和死亡率。文中简要讨论了早期和延迟并发症。适当选择导管插入部位、导管类型、严格的无菌插入程序以及对导管和插入部位的最佳护理对于避免并发症至关重要。
