Anand Preeti, Joshi Minal, Ahmed Khaja, Yarmush Joel
New York Presbyterian Brooklyn Methodist Hospital, USA.
Case Rep Anesthesiol. 2019 Jul 22;2019:5134575. doi: 10.1155/2019/5134575. eCollection 2019.
Central venous cannulation is a commonly performed procedure while managing critically ill patients; increasingly we encounter patients with indwelling wires or devices, like pacemakers, implantable cardioverter defibrillator devices, and peripherally inserted central venous catheters which complicate insertion of central venous catheters further. We present two cases where use of standard J-tip guidewire may have exacerbated the difficulty associated with internal jugular cannulation in presence of peripherally inserted central venous catheters. Recognition and avoidance of possible complications are crucial, and we discuss complexity posed by indwelling peripherally inserted central venous catheters and possible solutions.
中心静脉置管是在治疗重症患者时常用的操作；我们越来越多地遇到带有留置导线或装置的患者，如起搏器、植入式心脏复律除颤器装置以及外周静脉穿刺中心静脉导管，这些会使中心静脉导管的插入进一步复杂化。我们介绍两例病例，在存在外周静脉穿刺中心静脉导管的情况下，使用标准J型头导丝可能加剧了颈内静脉置管的难度。认识并避免可能的并发症至关重要，我们讨论了外周静脉穿刺中心静脉导管留置带来的复杂性及可能的解决办法。
