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急诊科超声引导下中心静脉导管置入术:哥伦比亚波哥大一家医院的经验

Ultrasound-guided central venous catheter placement in the emergency department: experience in a hospital in Bogotá, Colombia.

作者信息

Devia Jaramillo German, Torres Castillo Jenny, Lozano Freddy, Ramírez Angélica

机构信息

Emergency Medicine Department, Universidad del Rosario, Resuscitation Unit, Hospital Universitario Mayor Méderi, Bogotá, Colombia.

Resuscitation Unit, University Hospital Mayor Méderi, Bogotá, Colombia.

出版信息

Open Access Emerg Med. 2018 May 24;10:61-65. doi: 10.2147/OAEM.S150966. eCollection 2018.

Abstract

INTRODUCTION

The use of central venous catheters (CVCs) in the emergency room (ER) is a valuable tool for the comprehensive management of critically ill patients; however, the positioning of these devices is not free of complications. Currently, the use of ultrasound is considered a useful and safe tool to carry out these procedures, but in Colombia, the number of emergency departments providing this tool is scarce and there is no literature describing the experience in our country.

OBJECTIVE

The objective of this study was to describe the experience regarding placement of ultrasound-guided CVCs by emergency physicians in an institution in Bogotá, as well as the associated complications.

MATERIALS AND METHODS

This is a descriptive cross-sectional retrospective study. Medical records of 471 patients requiring insertion of CVCs in the resuscitation area from January 2014 to December 2014 were reviewed. Insertion site and complications are described.

RESULTS

For 471 total cases, the average age of patients was 68.6 years, the most frequent diagnosis was sepsis (30.7%), the preferred route of insertion was the right internal jugular vein, and insertion was successful at the first attempt in 85.9% of patients. Pneumothorax was the most common complication (1.2%), followed by extensive hematoma and infection.

CONCLUSION

Insertion of ultrasound-guided CVCs by emergency physicians is a safe procedure that involves complications similar to those reported in the literature; it is necessary to expand the use of ultrasound-guided CVCs in ERs.

摘要

引言

在急诊室使用中心静脉导管(CVC)是危重症患者综合管理的一项重要工具;然而,这些装置的放置并非没有并发症。目前,超声的使用被认为是进行这些操作的一种有用且安全的工具,但在哥伦比亚,配备这种工具的急诊科数量稀少,且没有文献描述我国在此方面的经验。

目的

本研究的目的是描述波哥大一家机构的急诊医生进行超声引导下中心静脉导管置入的经验以及相关并发症。

材料与方法

这是一项描述性横断面回顾性研究。回顾了2014年1月至2014年12月在复苏区需要置入中心静脉导管的471例患者的病历。描述了置入部位和并发症情况。

结果

在471例总病例中,患者的平均年龄为68.6岁,最常见的诊断是脓毒症(30.7%),首选的置入途径是右颈内静脉,85.9%的患者首次尝试置入成功。气胸是最常见的并发症(1.2%),其次是广泛血肿和感染。

结论

急诊医生进行超声引导下中心静脉导管置入是一种安全的操作,其并发症与文献报道的相似;有必要在急诊室扩大超声引导下中心静脉导管置入的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eae/5973354/b7402390d7f9/oaem-10-061Fig1.jpg

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