Emerman C L, Bellon E M, Lukens T W, May T E, Effron D
Department of Emergency Medicine, Case Western Reserve University, Cleveland, Ohio 44109.
Ann Emerg Med. 1990 Jan;19(1):26-30. doi: 10.1016/s0196-0644(05)82135-3.
Femoral vein catheterization has advantages over subclavian vein catheterization during cardiac arrest in that there is minimal interference to ongoing CPR. In addition, risks of subclavian catheterization are not a factor in femoral vein catheterization. Few studies have compared the success rate for catheterization of one site with that of the other during cardiac arrest. We conducted a prospective study to compare the success and complication rates for femoral with those of subclavian vein catheterization. Ninety-four patients undergoing CPR had either femoral or subclavian vein catheters placed during the course of the arrest. Catheter placement was verified by injection of radiopaque contrast material. We found that the success rate for femoral catheterization was 77% compared with a success rate of 94% for subclavian vein catheterization (P less than .05). There were no instances of pneumothorax with subclavian vein catheterization. There was no apparent learning curve leading to an increased success rate during the course of the study. We conclude that femoral vein catheterization should not be used except in those instances where attempts at peripheral and central venous cannulation are unsuccessful.
在心脏骤停期间，股静脉置管相较于锁骨下静脉置管具有优势，因为其对正在进行的心肺复苏干扰极小。此外，锁骨下静脉置管的风险在股静脉置管中并非影响因素。很少有研究比较心脏骤停期间一个部位与另一个部位的置管成功率。我们进行了一项前瞻性研究，以比较股静脉与锁骨下静脉置管的成功率和并发症发生率。94例接受心肺复苏的患者在心脏骤停过程中接受了股静脉或锁骨下静脉置管。通过注入不透射线的造影剂来确认导管放置情况。我们发现股静脉置管的成功率为77%，而锁骨下静脉置管的成功率为94%（P小于0.05）。锁骨下静脉置管未出现气胸病例。在研究过程中，没有明显的学习曲线导致成功率增加。我们得出结论，除非外周和中心静脉穿刺尝试均不成功，否则不应使用股静脉置管。
