Pacilli Maurizio, Bradshaw Catherine J, Clarke Simon A
1 Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, VIC, Australia.
2 Department of Paediatrics, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
J Vasc Access. 2018 Sep;19(5):496-500. doi: 10.1177/1129729818761278. Epub 2018 Mar 12.
Medium-term intravenous access in children is normally achieved by means of repeated multiple peripheral intravenous cannula insertions or peripherally inserted central catheters. Long peripheral cannulas might offer an alternative to these devices in children. Our aim was to clarify whether long peripheral cannulas provide reliable medium-term intravenous access avoiding the need for multiple peripheral intravenous cannulations or peripherally inserted central catheter insertion in children undergoing surgery.
Following ethical approval, we prospectively collected data in children requiring medium-term intravenous access. The 22G-8-cm-long peripheral cannulas were inserted with a Seldinger technique in a peripheral vein. Position was checked by flushing and aspirating the catheter. Results are reported as mean ± standard deviation.
A total of 18 children were included. Indications for medium-term intravenous therapy included perforated appendicitis (n = 14), infected central venous port (n = 2), fungal infection (n = 1) and septic arthritis (n = 1). In all, 15 (83%) patients underwent the procedure under general anaesthetic. The procedure failed in an 8-year-old patient. Insertion time was 8 ± 3.7 min. Age at insertion was 6.3 ± 4.9 years. Duration of intravenous therapy was 6.4 ± 5.1 days. About 13 (76%) patients completed the treatment with no complications. Three (17%) lines occluded by day 3 needed removal; one (7%) line needed removal on day 3 because of redness/pain noted around the insertion site.
Long peripheral cannulas represent a valid option for medium-term intravenous access in children undergoing surgery. Majority of patients will be successfully treated with one long peripheral cannula for the duration of their treatment without the need for further cannulation.
儿童中期静脉通路通常通过反复多次外周静脉置管或外周静脉穿刺中心静脉导管来实现。长外周静脉导管可能为儿童提供这些设备的替代方案。我们的目的是明确长外周静脉导管是否能提供可靠的中期静脉通路，从而避免在接受手术的儿童中进行多次外周静脉置管或外周静脉穿刺中心静脉导管置管。
经伦理批准后，我们前瞻性地收集了需要中期静脉通路的儿童的数据。采用Seldinger技术将22G-8厘米长的外周静脉导管插入外周静脉。通过冲洗和抽吸导管检查其位置。结果以平均值±标准差报告。
共纳入18名儿童。中期静脉治疗的适应证包括穿孔性阑尾炎（n = 14）、感染的中心静脉端口（n = 2）、真菌感染（n = 1）和化脓性关节炎（n = 1）。总计15名（83%）患者在全身麻醉下接受该操作。一名8岁患者操作失败。插入时间为8±3.7分钟。插入时年龄为6.3±4.9岁。静脉治疗持续时间为6.4±5.1天。约13名（76%）患者完成治疗且无并发症。3条（17%）在第3天堵塞的导管需要拔除；1条（7%）导管因插入部位周围出现发红/疼痛在第3天需要拔除。
长外周静脉导管是接受手术儿童中期静脉通路的有效选择。大多数患者在治疗期间使用一根长外周静脉导管即可成功治疗，无需进一步置管。
