Weber Mark D, Himebauch Adam S, Conlon Thomas
Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
J Vasc Access. 2024 Jan;25(1):323-326. doi: 10.1177/11297298221099138. Epub 2022 May 27.
Tunneled femorally inserted central catheters (FICCs) are frequently required for central access in children when upper extremity vessels cannot or should not be cannulated. A recently published decision tool for tunneled FICCs identifies the medial thigh as the preferred exit site. In pediatric patients, this medial exit site may remain at risk of contamination from stool due to anatomic size, and there are no tools developed for FICC exit site decisions specific to children. We present our approach for the placement of the exit site in the far lateral region of the thigh and review previous FICC literature relevant to the pediatric population. In select patients, a lateral approach has the potential to decrease the risk of exit site contamination to prolong catheter viability and reduce patient harm.
当无法或不应在上肢血管进行插管时,经隧道股静脉置入中心静脉导管(FICC)常用于儿童的中心静脉通路建立。最近发布的一种用于经隧道FICC的决策工具将大腿内侧确定为首选出口部位。在儿科患者中,由于解剖结构的原因,这个内侧出口部位可能仍有受到粪便污染的风险,而且还没有专门为儿童FICC出口部位决策开发的工具。我们介绍了在大腿最外侧区域放置出口部位的方法,并回顾了以往与儿科人群相关的FICC文献。在特定患者中,外侧入路有可能降低出口部位污染的风险,从而延长导管使用寿命并减少对患者的伤害。