Midha Devinder, Chawla Vipal, Kumar Arun, Mandal Amit Kumar
Department of Pulmonology and Critical Care, Fortis Hospital, Mohali, Punjab, India.
Institute of Gastro and Liver Transplant, Medanta - The Medicity, Gurgaon, Haryana, India.
Indian J Crit Care Med. 2017 Jul;21(7):463-465. doi: 10.4103/ijccm.IJCCM_61_17.
Ultrasound (USG) guidance has long been used for guiding central venous catheterization. USG provides direct visualization of needle puncture through the skin into the vein. Most of the time USG guidance is just limited to puncturing of the vein and seeing guidewire entering the vein while malpositioning of catheter occurs after that which is seen later on while checking chest radiograph. Repositioning of catheter after that becomes not only difficult requiring repeated chest radiograph to reconfirm position of catheter but also increases chances of infection with repeated manipulations. USG guidance can be used for tracing both guidewire and catheter during the procedure to prevent malpositioning of catheter, thus when done at the right time can prevent complication related to malpositioning and repeated manipulations. We used linear USG probe to check malposition of guidewire and microconvex probe to confirm position of central venous catheter.
超声（USG）引导长期以来一直用于指导中心静脉置管。超声可直接显示穿刺针经皮肤进入静脉的过程。大多数情况下，超声引导仅局限于静脉穿刺以及看到导丝进入静脉，而导管位置异常在此之后才会出现，后续在检查胸部X线片时才能发现。此后重新放置导管不仅困难，需要反复进行胸部X线片检查以重新确认导管位置，而且反复操作会增加感染几率。在操作过程中，超声引导可用于追踪导丝和导管，以防止导管位置异常，因此在合适的时间进行操作可预防与位置异常及反复操作相关的并发症。我们使用线性超声探头检查导丝位置异常，使用微凸探头确认中心静脉导管位置。
