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[新生儿和婴儿的动脉及中心静脉导管]

[Arterial and central venous catheters in neonates and infants].

作者信息

Stocker M, Berger T M

机构信息

Neonatologische und pädiatrische Intensivpflegestation, Kinderspital, 6000 Luzern, Schweiz.

出版信息

Anaesthesist. 2006 Aug;55(8):873-82. doi: 10.1007/s00101-006-1052-1.

Abstract

In neonates and infants, arterial and central venous catheters are of vital importance to optimize perioperative surveillance during surgery as well as postoperative care in the intensive care unit. The insertion of umbilical venous (UVC) and umbilical arterial catheters (UAC) in neonates in the first days of life is relatively simple and associated with a low procedure-related risk. As with other centrally placed catheters, correct positioning must be verified and the catheters should not be used for more than 5-7 days. Peripherally inserted central catheters (PICC) are commonly used in neonates and can be an alternative to conventional central venous lines in older infants. In order to minimize the risk associated with catheter malposition, correct position must always be verified by appropriate imaging studies or ECG guidance. Surgically placed Broviac catheters are mainly used in patients with a long-term need for central venous access. Finally, it has been shown that adherence to strict guidelines for insertion and handling can significantly reduce catheter-associated infections.

摘要

在新生儿和婴儿中,动脉导管和中心静脉导管对于优化手术期间的围手术期监测以及重症监护病房的术后护理至关重要。在新生儿出生后的头几天插入脐静脉导管(UVC)和脐动脉导管(UAC)相对简单,且与较低的操作相关风险相关。与其他中心放置的导管一样,必须验证正确的位置,并且导管使用时间不应超过5至7天。外周插入中心静脉导管(PICC)常用于新生儿,并且可以替代较大婴儿的传统中心静脉导管。为了将与导管位置不当相关的风险降至最低,必须始终通过适当的影像学检查或心电图引导来验证正确的位置。外科放置的Broviac导管主要用于长期需要中心静脉通路的患者。最后,研究表明,严格遵守插入和处理指南可以显著减少导管相关感染。

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