Akaraborworn Osaree
Division of Trauma and Surgical Critical Care, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Chin J Traumatol. 2017 Jun;20(3):137-140. doi: 10.1016/j.cjtee.2017.03.003. Epub 2017 May 17.
Central venous catheterization is widely used in the emergency setting. This review aims to assess central venous catheterization from the perspectives of types of catheters, sites of insertion, and techniques. In emergency conditions, non-tunneled catheters are preferred because the technique for its insertion is not complicated and less time-consuming. The size of catheter depends on the purpose of catheterization. For example, a large bore catheter is needed for rapid infusion. The ideal catheterization site should bear fewer thromboses, lower infectious rate, and fewer mechanical complications. Thus the femoral vein should be avoided due to a high rate of colonization and thrombosis while the subclavian vein seems to exhibit fewer infectious complications compared with other sites. The ultrasound-guided technique increases the success rate of insertion while decreases the mechanical complications rate.
中心静脉置管在急诊环境中广泛应用。本综述旨在从导管类型、插入部位和技术等方面评估中心静脉置管。在紧急情况下,非隧道式导管更受青睐,因为其插入技术不复杂且耗时较少。导管的尺寸取决于置管目的。例如,快速输液需要大口径导管。理想的置管部位应血栓形成较少、感染率较低且机械并发症较少。因此,由于定植和血栓形成率较高,应避免选择股静脉,而与其他部位相比,锁骨下静脉似乎感染并发症较少。超声引导技术可提高插入成功率,同时降低机械并发症发生率。