Eisen Lewis A, Narasimhan Mangala, Berger Jeffrey S, Mayo Paul H, Rosen Mark J, Schneider Roslyn F
Beth Israel Medical Center, Pulmonary Division, 7 Dazian, 17th Street at 1st Avenue, NY, NY 10010, USA.
J Intensive Care Med. 2006 Jan-Feb;21(1):40-6. doi: 10.1177/0885066605280884.
We analyzed 385 consecutive central venous catheter (CVC) attempts over a 6-month period. All critically ill patients 18 years of age or older requiring a CVC were included. The rate of mechanical complications not including failure to place was 14%. Complications included failure to place the CVC (n = 86), arterial puncture (n = 18), improper position (n = 14), pneumothorax (n = 5 in 258 subclavian and internal jugular attempts), hematoma (n = 3), hemothorax (n = 1), and asystolic cardiac arrest of unknown etiology (n = 1). Male patients had a significantly higher complication rate than female patients (37% vs 27%, P = .04). The subclavian approach had a higher complication rate than the internal jugular or the femoral approach (39% vs 33% vs. 24%, P = .02). The complication rate increased with the number of percutaneous punctures, with a rate of 54% when more than 2 punctures were required.
我们在6个月的时间里分析了385例连续的中心静脉导管（CVC）置入尝试。纳入了所有18岁及以上需要置入CVC的重症患者。不包括置管失败的机械并发症发生率为14%。并发症包括CVC置管失败（n = 86）、动脉穿刺（n = 18）、位置不当（n = 14）、气胸（258次锁骨下和颈内静脉置管尝试中有5例，n = 5）、血肿（n = 3）、血胸（n = 1）以及病因不明的心脏停搏（n = 1）。男性患者的并发症发生率显著高于女性患者（37%对27%，P = 0.04）。锁骨下途径的并发症发生率高于颈内静脉或股静脉途径（39%对33%对24%，P = 0.02）。并发症发生率随经皮穿刺次数的增加而升高，当需要超过2次穿刺时发生率为54%。
