Meyer Pascal, Cronier Pierrick, Rousseau Hélène, Vicaut Eric, Choukroun Gerald, Chergui Karim, Chevrel Guillaume, Maury Eric
Intensive Care Unit, Centre Hospitalier Sud-Francilien, 91106 Corbeil-Essonnes Cedex, France.
Intensive Care Unit, Centre Hospitalier Sud-Francilien, 91106 Corbeil-Essonnes Cedex, France.
J Crit Care. 2014 Oct;29(5):823-7. doi: 10.1016/j.jcrc.2014.04.022. Epub 2014 May 9.
A preliminary observational study was undertaken to evaluate the risk of failure of ultrasound-guided peripheral intravenous catheterization of a deep arm vein for a maximum of 7 days, after peripheral intravenous (PIV) cannulation failure.
This prospective study included patients referred to the intensive care unit for placement of a central line, a polyurethane cannula commercialized for arterial catheterization was used for peripheral venous cannulation. Catheter length and diameter were chosen based on preliminary ultrasound measurements of vein diameter and skin-vein distance.
Catheterization was successful for all 29 patients. Mean vein diameter was 0.42 ± 0.39 cm; mean vein depth was 0.94 ± 0.52 cm. Mean catheter duration was 6 (median 7) days. Two occluded catheters were removed prematurely. No thrombophlebitis, catheter infection, or extravasation was observed.
Our results suggest that catheters inserted with the Seldinger method are adapted to prolonged peripheral deep-vein infusion. Ultrasound can play a role in catheter monitoring by identifying early thrombosis formation.
进行一项初步观察性研究，以评估在外周静脉（PIV）置管失败后，超声引导下进行上臂深静脉置管并保留最长7天的失败风险。
这项前瞻性研究纳入了因需要放置中心静脉导管而转入重症监护病房的患者，使用一种用于动脉导管插入术的商业化聚氨酯套管进行外周静脉置管。根据术前超声测量的静脉直径和皮肤-静脉距离选择导管的长度和直径。
29例患者均置管成功。平均静脉直径为0.42±0.39厘米；平均静脉深度为0.94±0.52厘米。平均导管留置时间为6（中位数7）天。两根堵塞的导管被提前拔除。未观察到血栓性静脉炎、导管感染或外渗。
我们的结果表明，采用Seldinger法插入的导管适用于长时间的外周深静脉输液。超声可通过识别早期血栓形成在导管监测中发挥作用。
