Schindler Ehrenfried, Mikus Marian, Velten Markus
Anasthesiol Intensivmed Notfallmed Schmerzther. 2021 Jan;56(1):60-68. doi: 10.1055/a-1187-5397. Epub 2021 Jan 7.
Children with complex diseases often need central venous catheter, not only for intraoperative use, but also for parenteral nutrition, multiple blood draw due to lab examination and to administer drugs that cannot be given via peripheral lines. Whereas the landmark driven vascular access was teached for years, nowadays the routine use of ultrasound based techniques can be called the gold standard. This article highlights standard locations for central venous access like cannulation of the internal jugular vein as well as novel alternatives such as the cannulation of the brachiocephalic vein. The correct insertion depth of central lines is essential to avoid serious complications. Several different formulas are available and can be used. Independent of the used formula, you have to make sure that complications due to incorrect depth of central venous line are a topic of the past. Finally, important tips and tricks to avoid failure and serious complications are discussed.
患有复杂疾病的儿童通常需要中心静脉导管，不仅用于术中，还用于肠外营养、因实验室检查而多次采血以及输注不能通过外周静脉给药的药物。尽管多年来一直教授基于体表标志的血管通路技术，但如今基于超声的技术的常规应用堪称金标准。本文重点介绍中心静脉置管的标准部位，如颈内静脉置管，以及一些新的替代方法，如头臂静脉置管。中心静脉导管的正确插入深度对于避免严重并发症至关重要。有几种不同的公式可供使用。无论使用哪种公式，都必须确保因中心静脉导管插入深度不正确而导致的并发症成为过去式。最后，讨论了避免失败和严重并发症的重要技巧。
