Haas Nikolaus A
Paediatric Intensive Care Unit, The Prince Charles Hospital, Brisbane, Australia.
Crit Care. 2004 Dec;8(6):478-84. doi: 10.1186/cc2880. Epub 2004 Jun 3.
The current literature on venous access in infants and children for acute intravascular access in the routine situation and in emergency or intensive care settings is reviewed. The various techniques for facilitating venous cannulation, such as application of local warmth, transillumination techniques and epidermal nitroglycerine, are described. Preferred sites for central venous access in infants and children are the external and internal jugular veins, the subclavian and axillary veins, and the femoral vein. The femoral venous cannulation appears to be the most safe and reliable technique in children of all ages, with a high success and low complication rates. Evidence from the reviewed literature strongly supports the use of real-time ultrasound techniques for venous cannulation in infants and children. Additionally, in emergency situations the intraosseous access has almost completely replaced saphenous cutdown procedures in children and has decreased the need for immediate central venous access.
本文回顾了当前关于婴儿和儿童在常规情况以及急诊或重症监护环境下进行急性血管内穿刺的静脉通路的文献。描述了多种促进静脉置管的技术，如局部热敷、透照技术和表皮应用硝酸甘油。婴儿和儿童中心静脉通路的首选部位是颈外静脉和颈内静脉、锁骨下静脉和腋静脉以及股静脉。股静脉置管似乎是所有年龄段儿童最安全可靠的技术，成功率高且并发症发生率低。综述文献的证据有力支持在婴儿和儿童静脉置管中使用实时超声技术。此外，在紧急情况下，骨内通路几乎完全取代了儿童的大隐静脉切开术，减少了立即进行中心静脉通路的需求。
