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先天性心脏病手术患儿在超声引导下行颈内静脉置管的成功率及安全性

The success rate and safety of internal jugular vein catheterization under ultrasound guidance in infants undergoing congenital heart surgery.

作者信息

Altun Dilek, Nuraç Salih Hakan, Toprak Verda, Eti Emine Zeynep

机构信息

Department of Anesthesiology and Reanimation, Bakırköy Acıbadem Hospital, Istanbul, Turkey.

Department of Anesthesiology and Reanimation, Başkent University İstanbul Health Application and Research Center Hospital, Istanbul, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jan 1;27(1):23-28. doi: 10.5606/tgkdc.dergisi.2019.16185. eCollection 2019 Jan.

Abstract

BACKGROUND

In this study, we aimed to investigate the effect of central venous catheterization under ultrasound guidance on the success and complication rates in low-weight infants (under 5 kg) undergoing surgery due to congenital heart disease.

METHODS

A total of 70 infants (38 boys, 32 girls; mean age of patients <1 month was 16.4±9.5 days [n=20; 28.6%]; 1-7.5 months was 126.3±47.8 [n=50; 71.4%]) who underwent ultrasound-guided internal jugular venous catheterization between October 2014 and October 2015 were retrospectively analyzed. All catheterizations were done under the guidance of ultrasound by two skilled anesthesiologists. Data including demographic characteristics of the patients, procedural success rate, catheter access time, number of attempts, and complications were recorded.

RESULTS

The overall success rate of the procedure was 92.8% (n=65). In 82% of the patients (n=53), the insertion was successful at the first attempt. The mean catheter access time (time from the first puncture to the catheter insertion) was 214±0.48 sec. Complications were seen in five patients (7.14%), and the body weight of these patients was less than 2,500 g. There was no arterial puncture in any patients. One patient (1.42%) developed pneumothorax and four patients (5.7%) developed hematoma due to repeated attempts.

CONCLUSION

Our study results suggest that ultrasound-guided central venous cannulation is a safe and effective technique in pediatric population weighing less than 5 kg undergoing congenital heart surgery.

摘要

背景

在本研究中,我们旨在探讨超声引导下中心静脉置管对因先天性心脏病接受手术的低体重婴儿(体重低于5 kg)置管成功率和并发症发生率的影响。

方法

回顾性分析2014年10月至2015年10月期间接受超声引导下颈内静脉置管的70例婴儿(38例男婴,32例女婴;年龄小于1个月的患者平均年龄为16.4±9.5天[n = 20;28.6%];1至7.5个月的患者平均年龄为126.3±47.8天[n = 50;71.4%])。所有置管均由两名技术熟练的麻醉医生在超声引导下完成。记录患者的人口统计学特征、操作成功率、导管置入时间、尝试次数和并发症等数据。

结果

该操作的总体成功率为92.8%(n = 65)。82%的患者(n = 53)首次置管成功。平均导管置入时间(从首次穿刺到导管置入的时间)为214±0.48秒。5例患者(7.14%)出现并发症,这些患者的体重均小于2500 g。所有患者均未发生动脉穿刺。1例患者(1.42%)发生气胸,4例患者(5.7%)因多次尝试出现血肿。

结论

我们的研究结果表明,超声引导下中心静脉置管对于体重低于5 kg接受先天性心脏病手术的儿科患者是一种安全有效的技术。

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