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在重症监护环境中,同时在右颈内静脉内置入透析和输液导管:安全吗?

Concomitant placement of dialysis and infusion catheters in the right internal jugular vein in the intensive care setting: Is it safe?

机构信息

Department of Surgery, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.

Department of Medical Education, Ascension Via Christi Hospital Saint Francis, Wichita, KS, USA.

出版信息

J Vasc Access. 2021 May;22(3):359-363. doi: 10.1177/1129729820938209. Epub 2020 Jul 15.

Abstract

PURPOSE

This study examined the safety and efficacy of placing both a central venous dialysis catheter and a central venous catheter for infusion in the right internal jugular vein compared to only a central venous dialysis catheter.

METHODS

We conducted a retrospective chart review for all adult patients who underwent the placement of the right internal jugular dialysis catheter by a single surgeon. Patients were grouped based on whether they received a tunneled dual lumen dialysis catheter alone or in combination with a central venous infusion catheter in the right internal jugular vein. Catheter-related thrombosis, line infections, line malfunctions, pneumothorax, and need for line replacement were evaluated.

RESULTS

There were 97 patients in the dialysis catheter and central venous infusion line group and 63 patients in the dialysis catheter only group. The two groups were not different with regard to age (62.1 ± 16.3 years vs 57.9 ± 17.6 years) and gender (47.4% male vs 55.6% male). No significant differences were found in the incidence of thrombosis (1.0 % vs 0.0%,  > 0.999), line infection (2.1% vs 0.0%,  = 0.519), or line malfunctions (2.1% vs 0.0%,  = 0.516) in patients who did or did not have a central venous infusion catheter placed concomitantly with the dialysis catheter, respectively. No patients in either group had a pneumothorax.

CONCLUSIONS

Although not currently utilized with frequency, these preliminary data indicate that placing both a dual lumen dialysis catheter and central venous infusion catheter in the right internal jugular simultaneously could be a viable option.

摘要

目的

本研究旨在评估与仅置入中心静脉透析导管相比,同时在右颈内静脉中置放中心静脉透析导管和中心静脉输液导管的安全性和有效性。

方法

我们对由同一位外科医生置放右颈内静脉透析导管的所有成年患者进行了回顾性图表审查。患者根据是否单独接受经隧道双腔透析导管或同时在右颈内静脉中接受中心静脉输液导管分组。评估导管相关性血栓形成、导管相关感染、导管功能障碍、气胸和导管更换需求。

结果

透析导管和中心静脉输液导管组有 97 例患者,透析导管组仅有 63 例患者。两组在年龄(62.1±16.3 岁 vs 57.9±17.6 岁)和性别(47.4%男性 vs 55.6%男性)方面无差异。同时置放和未同时置放中心静脉输液导管的患者在血栓形成(1.0% vs 0.0%, > 0.999)、导管感染(2.1% vs 0.0%, = 0.519)或导管功能障碍(2.1% vs 0.0%, = 0.516)的发生率方面无显著差异。两组均无患者发生气胸。

结论

尽管目前并未广泛应用,但这些初步数据表明,同时在右颈内静脉中置放双腔透析导管和中心静脉输液导管可能是一种可行的选择。

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