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儿童外周置入中心静脉导管(PICC)更换技术。

Technique for replacement of Groshong® peripherally inserted central venous catheters (PICCs) in children.

机构信息

Department of Pediatric Surgery, Children's Hospital, ASST-Spedali Civili of Brescia, Brescia, Italy -

Department of Pediatric Surgery, Children's Hospital, ASST-Spedali Civili of Brescia, Brescia, Italy.

出版信息

Minerva Pediatr (Torino). 2022 Aug;74(4):403-407. doi: 10.23736/S2724-5276.20.05806-5. Epub 2020 Apr 9.

Abstract

BACKGROUND

The use of peripherally inserted central catheters (PICCs) in children is increasingly common due to their certain advantages and low rate of adverse events. Valved PICCs, when displaced, must be removed and new a PICC must be placed in another vein. We present our PICC replacement technique over a Seldinger guidewire using the same entrance vein.

METHODS

This prospective study involved all consecutive patients with a previously inserted Groshong PICC (Bard Access Systems Inc., Salt Lake City, UT, USA) requiring replacement due to displacement managed at our institution between January 2018 and January 2019. All procedures were performed at the patients' bedside, under local anesthesia. All the steps of the procedure were described.

RESULTS

The procedure was performed in 19 patients (mean 10.4 years, range 5-18 years) in a mean time of 12 minutes (range 10-35). In all cases, the maneuver was quick and painless. No complications were encountered during the procedure and at follow-up.

CONCLUSIONS

Our preliminary experience suggests that the PICC replacement technique using the same entrance vein is simple, safe, and feasible, and provides clear benefits to preserve children's venous patrimony.

摘要

背景

由于外周中心静脉置管(PICC)具有一定的优势且不良事件发生率较低,因此在儿童中越来越多地使用。带阀 PICC 一旦移位,必须将其取出,并在另一条静脉中重新放置新的 PICC。我们介绍了一种使用相同入口静脉的经 Seldinger 导丝更换 PICC 的技术。

方法

本前瞻性研究纳入了 2018 年 1 月至 2019 年 1 月期间在我院因移位而需要更换的所有连续接受过先前插入的 Groshong PICC(Bard Access Systems Inc.,盐湖城,犹他州,美国)的患者。所有操作均在患者床边,局部麻醉下进行。描述了该程序的所有步骤。

结果

19 名患者(平均年龄 10.4 岁,范围 5-18 岁)在平均 12 分钟(范围 10-35)内完成了该程序。在所有情况下,操作快速且无痛。在手术过程中和随访期间均未发生任何并发症。

结论

我们的初步经验表明,使用相同入口静脉的 PICC 更换技术简单、安全且可行,可明确保留儿童的静脉资源。

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