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中心静脉导管置入过程中意外动脉插管的处理:病例系列

Management of Inadvertent Arterial Catheterization during Central Venous Catheter Placement: A Case Series.

作者信息

Papastratigakis Georgios, Marouli Diamantina, Proklou Athanasia, Nasis Nikolaos, Kondili Eumorfia, Kehagias Elias

机构信息

Department of Anesthesiology, University Hospital of Heraklion, Voutes, 71110 Heraklion, Greece.

Department of Intensive Care, University Hospital of Heraklion and Medical School, University of Crete, Voutes, 71110 Heraklion, Greece.

出版信息

J Pers Med. 2022 Sep 19;12(9):1537. doi: 10.3390/jpm12091537.

Abstract

Percutaneous central venous catheterization, although a widely used technique in ICU patients worldwide, is not devoid of complications even under real-time ultrasound guidance. Arterial puncture is a well-recognized complication, while unintended subclavian or carotid artery cannulations during attempted central venous catheterization are infrequent, but documented complications with potentially deleterious consequences. Recently, endovascular balloon tamponade has emerged as the preferred initial approach to repair inadvertent arterial cannulations. Herein, we present a case series of inadvertent arterial catheterization during an attempted ultrasound-guided access of the right internal jugular and the left subclavian vein that were successfully managed with endovascular balloon tamponade.

摘要

经皮中心静脉置管术虽然在全球范围内的重症监护病房患者中广泛应用,但即使在实时超声引导下也并非没有并发症。动脉穿刺是一种公认的并发症,而在尝试中心静脉置管过程中意外的锁骨下或颈动脉插管虽不常见,但却是有文献记载且可能产生有害后果的并发症。最近,血管内球囊压迫已成为修复意外动脉插管的首选初始方法。在此,我们报告一组病例,这些病例是在尝试超声引导下穿刺右侧颈内静脉和左侧锁骨下静脉时发生的意外动脉插管,均通过血管内球囊压迫成功处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fce8/9503793/47b49dc2612b/jpm-12-01537-g001.jpg

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