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经股静脉穿刺置入中心静脉导管在极低出生体重儿中的应用:单中心经验。

Percutaneous Inserted Venous Catheter via Femoral Vein in Extremely Low-Birth-Weight Infants: A Single-Center Experience.

机构信息

Department of Neonatology, Biomedical Research Institute i + 12, Hospital 12 de Octubre, Madrid, Spain.

Department of Neonatology, Hospital 12 de Octubre, Madrid, Spain.

出版信息

Am J Perinatol. 2020 Dec;37(14):1432-1437. doi: 10.1055/s-0039-1693718. Epub 2019 Aug 9.

Abstract

OBJECTIVE

This study aimed to assess the applicability of the insertion of small diameter catheters through the femoral vein in extremely low-birth-weight (ELBW) infants.

STUDY DESIGN

All femoral small diameter catheters (Silastic or femoral arterial catheter [FAC]) inserted in ELBW infants in a tertiary level neonatal intensive care unit were retrospectively reviewed. Success rate, dwelling time, and percutaneously inserted central venous catheter-related complications were recorded.

RESULTS

Thirteen small diameter catheters were inserted in seven ELBW infants. Mean gestational age at birth was 25 weeks (standard deviation [SD] ± 2.12) and mean birth weight was 686 g (SD ± 204.9). Mean weight at the first time of insertion was 1,044 g (SD ± 376.3). In two occasions, a FAC was used instead of a Silastic. In most cases (11/13, 84.6%), the patient was intubated prior to the procedure. The mean dwelling time was 16.7 days (SD ± 9.8). Most of the inserted small diameter catheters were removed electively (8/12, 66.7%), except for one episode of clinical sepsis from coagulase-negative and three cases of accidental line extravasation. No other complications were reported. The success rate was 92.3%.

CONCLUSION

Femoral venous catheterization using small diameter catheters in ELBW infants may be promising when other routes have been exhausted. Our results support that it is a feasible technique that can be performed at the bedside with successful results when conducted by experienced personnel.

摘要

目的

本研究旨在评估经股静脉插入小直径导管在极低出生体重(ELBW)婴儿中的适用性。

研究设计

回顾性分析在三级新生儿重症监护病房中对 ELBW 婴儿插入股小直径导管(硅酮或股动脉导管[FAC])的所有病例。记录成功率、留置时间和经皮插入中心静脉导管相关并发症。

结果

7 例 ELBW 婴儿共插入 13 根小直径导管。出生时的平均胎龄为 25 周(标准差[SD]±2.12),平均出生体重为 686g(SD±204.9)。首次插入时的平均体重为 1044g(SD±376.3)。有两次使用了 FAC 代替硅酮。在大多数情况下(11/13,84.6%),患者在操作前进行了气管插管。平均留置时间为 16.7 天(SD±9.8)。除 1 例凝固酶阴性菌引起的临床败血症和 3 例导管意外外渗外,大多数插入的小直径导管均被择期拔出(8/12,66.7%)。未报告其他并发症。成功率为 92.3%。

结论

当其他途径用尽时,经股静脉插入小直径导管在 ELBW 婴儿中可能是有前途的。我们的结果支持这是一种可行的技术,当由经验丰富的人员进行操作时,可以在床边进行,并且可以获得成功的结果。

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