Kosiński Sylweriusz, Podsiadło Paweł, Stachowicz Jakub, Mikiewicz Maciej, Serafinowicz Zofia, Łukasiewicz Katarzyna, Mendrala Konrad, Darocha Tomasz
Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Institute of Medical Sciences, Jan Kochanowski University Medical College, Kielce, Poland.
J Vasc Access. 2023 Jul;24(4):754-761. doi: 10.1177/11297298211054629. Epub 2021 Nov 2.
Despite its potential advantages, ultrasound-guided cannulation of the axillary vein in the infraclavicular area is still rarely used as an alternative to other techniques. There are few large series demonstrating the safety and feasibility of this approach.
Retrospective analysis of data on patients undergoing ultrasound-guided, long-axis, in-plane infraclavicular axillary vein cannulation for the incidence of complications and the failure rate from two secondary-care hospitals.
The analysis included 710 successful attempts of axillary vein long-axis, in-plane, US-guided cannulation, and 24 (3.3%) failed attempts. We recorded a 96.7% success rate with an overall incidence of complications of 13%, mainly malposition (8.1%). There was one case of pneumothorax (0.14%), five cases of arterial puncture (0.7%), and two cases of brachial plexus injury.
The US-guided axillary central venous cannulation (CVC) access technique can be undertaken successfully in patients, even in challenging circumstances. Taken together with existing work on the utility and safety of this technique, we suggest that it should be adopted more widely in clinical practice.
尽管超声引导下锁骨下区域腋静脉置管具有潜在优势，但作为其他技术的替代方法，其使用仍然很少。很少有大型系列研究证明这种方法的安全性和可行性。
对两家二级护理医院中接受超声引导下、长轴、平面内锁骨下腋静脉置管患者的数据进行回顾性分析，以了解并发症发生率和失败率。
分析包括710例成功的腋静脉长轴、平面内、超声引导下置管尝试，以及24例（3.3%）失败尝试。我们记录的成功率为96.7%，并发症总发生率为13%，主要是位置不当（8.1%）。有1例气胸（0.14%）、5例动脉穿刺（0.7%）和2例臂丛神经损伤。
超声引导下腋静脉中心静脉置管（CVC）技术即使在具有挑战性的情况下也能在患者中成功实施。结合该技术实用性和安全性的现有研究，我们建议在临床实践中更广泛地采用该技术。
