Department of Intensive Care Medicine, Osaka Prefectural Hospital Organization, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.
Department of Intensive Care Medicine, Osaka Prefectural Hospital Organization, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.
J Cardiothorac Vasc Anesth. 2020 Jan;34(1):114-118. doi: 10.1053/j.jvca.2019.04.029. Epub 2019 May 2.
Although a few studies have reported the efficacy of ultrasound-guided peripherally inserted central catheter placement for pediatric patients, the procedure still is challenging. Ultrasound-guided dynamic needle tip positioning technique is useful for vascular catheterization. There have been no reports on using dynamic needle tip positioning for peripherally inserted central catheter placement. The authors assessed the rate of successful peripherally inserted central catheter placement with dynamic needle tip positioning.
Case series.
Single tertiary institution.
Forty patients <5 years old who were admitted to the pediatric intensive care unit after cardiac surgeries and required peripherally inserted central catheter placement.
Peripherally inserted central catheter placement was performed under ultrasound guidance with dynamic needle tip positioning. The authors recorded the first attempt and overall success rates of peripherally inserted central catheter and outer cannula placement, time needed for outer cannula and peripherally inserted central catheter placement, and number of attempts.
The first attempt and overall success rates of peripherally inserted central catheter placement were 85% (n = 34) and 97.5% (n = 39), respectively. The first attempt and overall success rates of outer cannula placement were 87.5% (n = 35) and 100% (n = 40), respectively. Time needed for outer cannula placement was 59.5 (interquartile range 40.5-80.5) seconds and for peripherally inserted central catheter placement was 112.5 (interquartile range 91.5-159.5) seconds. The number of attempts was 1 (interquartile range 1-1 [range 1-5]).
In pediatric patients, ultrasound-guided peripherally inserted central catheter placement using dynamic needle tip positioning attained a high success rate.
尽管有几项研究报告了超声引导下外周中心静脉导管置管术在儿科患者中的疗效，但该操作仍具有挑战性。超声引导下的动态针尖定位技术在血管置管中很有用。尚未有关于使用动态针尖定位进行外周中心静脉导管置管的报道。作者评估了使用动态针尖定位进行外周中心静脉导管置管的成功率。
病例系列。
单一的三级医疗机构。
40 名年龄<5 岁的患儿，他们在心脏手术后被收入儿科重症监护病房，需要进行外周中心静脉导管置管。
在超声引导下使用动态针尖定位进行外周中心静脉导管置管。作者记录了首次尝试和总体外周中心静脉导管和外套管置管成功率、外套管和外周中心静脉导管置管所需时间以及尝试次数。
首次尝试和总体外周中心静脉导管置管成功率分别为 85%（n=34）和 97.5%（n=39）。首次尝试和总体外套管置管成功率分别为 87.5%（n=35）和 100%（n=40）。外套管置管所需时间为 59.5 秒（四分位距 40.5-80.5），外周中心静脉导管置管所需时间为 112.5 秒（四分位距 91.5-159.5）。尝试次数为 1 次（四分位距 1-1[范围 1-5]）。
在儿科患者中，使用动态针尖定位的超声引导外周中心静脉导管置管术成功率较高。
