Abrams-Ogg A C, Kruth S A, Carter R F, Valli V E, Kamel-Reid S, Dubé I D
Department of Clinical Studies, Ontario Veterinary College, University of Guelph.
Can J Vet Res. 1992 Oct;56(4):382-6.
Methods were developed for the insertion and maintenance of long-term central venous catheters in dogs in order to provide reliable venous access during bone marrow transplantation. Single-lumen, 9.6 Fr Hickman catheters with a VitaCuff were used. The catheter was inserted into the jugular vein via a surgical cut-down, and tunnelled subcutaneously to exit over the thoracic spine. Fluoroscopic guidance was necessary to ensure proper positioning of the catheter tip in the right atrium. The catheter was secured at the venous entrance site with a grommet and at the cutaneous exit site with a finger-cuff suture. The exit site was bandaged; dressings were changed daily. Five dogs were studied. Catheter insertion and maintenance techniques were developed using two dogs. For the other three dogs, which developed 7 wk of profound myelosuppression induced by total body irradiation, the catheters were used for blood sampling and infusions of antibiotics, fluids, and blood products. For these three dogs there were 261 total catheter-days. Complete catheter obstruction did not occur. Partial obstruction (inability to withdraw blood) occurred for 13 days with one catheter. The tip of this catheter was in the cranial vena cava. One irradiated dog had a staphylococcal exit site infection for several days after catheter insertion, which resolved with antibiotic therapy. Infections of the subcutaneous tunnel, and catheter associated bacteremia, were not identified. Infectious and hemorrhagic complications of myelosuppression were less severe than in six other dogs where intermittent venipuncture was used for vascular access during radiation induced myelosuppression. In conclusion, long-term central venous catheterization is feasible in dogs during profound myelosuppression and markedly facilitates patient management.
为了在骨髓移植期间提供可靠的静脉通路，已开发出在犬体内插入和维护长期中心静脉导管的方法。使用了带有VitaCuff的单腔、9.6 Fr希克曼导管。通过手术切开将导管插入颈静脉，并在皮下隧道化，使其在胸椎上方穿出。需要荧光镜引导以确保导管尖端在右心房中的正确定位。导管在静脉入口处用索环固定，在皮肤出口处用指箍缝线固定。出口处用绷带包扎；每天更换敷料。对5只犬进行了研究。使用2只犬开发了导管插入和维护技术。对于另外3只因全身照射导致7周严重骨髓抑制的犬，导管用于采血以及输注抗生素、液体和血液制品。这3只犬的导管使用总天数为261天。未发生完全性导管阻塞。一根导管出现部分阻塞（无法抽血）持续了13天。该导管尖端位于头臂静脉。一只接受照射的犬在导管插入后数天出现葡萄球菌性出口部位感染，经抗生素治疗后痊愈。未发现皮下隧道感染和导管相关菌血症。骨髓抑制的感染性和出血性并发症比另外6只犬轻，在这6只犬中，在辐射诱导的骨髓抑制期间使用间歇性静脉穿刺进行血管通路。总之，在严重骨髓抑制期间，犬长期中心静脉置管是可行的，并且显著便于患者管理。
