Mitsuda Shingo, Tokumine Joho, Matsuda Rena, Yorozu Tomoko, Asao Takayuki
Department of Anesthesiology, Kyorin University School of Medicine, Sinkawa, Mitaka, Tokyo.
Big Data Center for Integrative Analysis, Gunma University Initiative for Advance Research, Showa, Maebashi, Gunnma, Japan.
Medicine (Baltimore). 2019 Feb;98(6):e14413. doi: 10.1097/MD.0000000000014413.
A peripherally inserted central catheter (PICC) is typically inserted with the patient in the supine position. Here, we placed a PICC in a patient in the sitting position, in order to treat congestive heart failure.
A 65-year-old man was diagnosed with end-stage lung cancer. He had experienced septic shock and was medicated with continuous infusion of noradrenaline through a peripheral vein, in order to maintain sufficient blood pressure. However, indwelling peripheral venous catheters were difficult to place and maintain.
The patient experienced orthopnea due to congestive heart failure and could not assume any other position.
An anesthesiologist performed PICC placement while the patient was in the sitting position, using ultrasound guidance.
The patient's orthopnea was slightly ameliorated, and he was able to sleep at night.
The technique of inserting a PICC in the sitting position is simple and feasible. This approach may be useful for patients in whom central venous access is needed, but the supine position cannot be achieved.
经外周静脉穿刺中心静脉导管（PICC）通常在患者仰卧位时插入。在此，我们为一名患者在坐位时放置了PICC，以治疗充血性心力衰竭。
一名65岁男性被诊断为晚期肺癌。他曾经历感染性休克，通过外周静脉持续输注去甲肾上腺素以维持足够的血压。然而，外周静脉留置导管难以放置和维护。
患者因充血性心力衰竭出现端坐呼吸，无法采取其他体位。
一名麻醉医生在患者坐位时，使用超声引导进行PICC放置。
患者的端坐呼吸稍有改善，能够夜间入睡。
坐位插入PICC的技术简单可行。这种方法对于需要中心静脉通路但无法采取仰卧位的患者可能有用。
