Department of Anesthesiology, Children's Mercy Hospital, University of Missouri - Kansas City School of Medicine, Kansas City, Missouri, USA.
Medical Student, School of Medicine, University of Missouri - Kansas City, Kansas City, Missouri, USA.
Paediatr Anaesth. 2021 Sep;31(9):996-1002. doi: 10.1111/pan.14246. Epub 2021 Jul 9.
Due to excess catheter length, pediatric patients undergoing cardiac surgery frequently have the tip of the central venous catheter trimmed while on bypass to obtain optimal catheter positioning.
We sought to determine if there is a correlation between the patient's height or weight and the length of catheter removed. Our secondary aim compared the instances of central line-associated bloodstream infections and venous thromboembolisms between the trimmed and untrimmed catheters.
This retrospective study included patients having undergone cardiac surgery over a 3-year period who had an 8 cm central venous catheter placed in the right internal jugular vein. Hospital lists of central line-associated bloodstream infections and venous thromboembolisms that occurred were cross referenced with our study patients.
There were 147 cases where the 8 cm central venous catheter was trimmed, which represents 35% of the cases. Of the catheters that were cut, on average 2.17 cm was removed. There is negligible correlation between the length of catheter removed and patient height (r = -.19, p = .021). There is negligible correlation between the length of catheter removed and patient weight (r = -.17, p = .039). There were no instances of central line-associated bloodstream infections or venous thromboembolisms attributed to the trimmed catheters. Of the 273 untrimmed catheters, there were no instances of an infection and one instance of a venous thromboembolism.
Right internal jugular 8 cm central venous catheters are trimmed during pediatric cardiac surgery, and there is minimal correlation between the length removed and the patient height or weight. Due to the difficulty in estimating the proper length of a central venous catheter in smaller pediatric patients, placing an 8 cm long catheter in these patients and then trimming the distal tip while on bypass may be the most accurate way to properly position a catheter.
由于导管过长，儿科患者在体外循环时经常需要修剪中心静脉导管的尖端，以获得最佳的导管位置。
我们旨在确定患者的身高或体重与切除的导管长度之间是否存在相关性。我们的次要目的是比较修剪和未修剪导管之间中心静脉导管相关血流感染和静脉血栓栓塞的发生率。
这项回顾性研究包括在 3 年期间接受心脏手术的患者，这些患者在右颈内静脉中放置了 8cm 的中心静脉导管。医院中心静脉导管相关血流感染和静脉血栓栓塞的清单与我们的研究患者交叉引用。
有 147 例 8cm 中心静脉导管被修剪，占 35%。在被切断的导管中，平均切除 2.17cm。切除的导管长度与患者身高之间几乎没有相关性（r = -.19，p =.021）。切除的导管长度与患者体重之间几乎没有相关性（r = -.17，p =.039）。没有因修剪的导管而导致的中心静脉导管相关血流感染或静脉血栓栓塞的病例。在 273 根未修剪的导管中，没有感染病例，有 1 例静脉血栓栓塞病例。
在儿科心脏手术中，右颈内静脉 8cm 中心静脉导管被修剪，切除的长度与患者身高或体重之间几乎没有相关性。由于在较小的儿科患者中难以估计中心静脉导管的适当长度，因此在这些患者中放置 8cm 长的导管，然后在体外循环时修剪远端尖端可能是正确定位导管的最准确方法。
