Vafek Václav, Skříšovská Tamara, Kosinová Martina, Klabusayová Eva, Musilová Tereza, Kramplová Tereza, Djakow Jana, Klučka Jozef, Kalina Jiří, Štourač Petr
Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic.
Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic.
Children (Basel). 2022 Oct 23;9(11):1611. doi: 10.3390/children9111611.
Currently, ultrasound-guided central venous catheter (CVC) insertion is recommended in pediatric patients. However, the clinical practice may vary. The primary aim of this study was the overall success rate and the first attempt success rate in ultrasound-guided CVC insertion versus anatomic-based CVC insertion in pediatric patients. The secondary aim was the incidence of associated complications and the procedural time. The physician could freely choose the cannulation method and venous approach. Data were collected for 10 months. Overall, 179 patients were assessed for eligibility and 107 patients were included. In almost half of the patients (48.6%), the percutaneous puncture was performed by real-time ultrasound navigation. In 51.4% of the patients, the puncture was performed by the landmark method. The overall success rate was 100% (n = 52) in the real-time ultrasound navigation group, 96.4% (n = 53) in the landmark insertion group, ( = 0.496). The first percutaneous puncture success rate was 57.7% (n = 30) in the real-time ultrasound navigation group and 45.5% (n = 25) in the landmark insertion group, ( = 0.460). The data show a higher overall success rate and the first success rate in the US-guided CVC insertion group, but the difference was not statistically significant.
目前，建议在儿科患者中采用超声引导下中心静脉导管（CVC）置入术。然而，临床实践可能存在差异。本研究的主要目的是比较儿科患者中超声引导下CVC置入术与基于解剖定位的CVC置入术的总体成功率和首次尝试成功率。次要目的是相关并发症的发生率和操作时间。医生可自由选择置管方法和静脉入路。数据收集为期10个月。总体而言，对179例患者进行了资格评估，纳入了107例患者。几乎一半的患者（48.6%）通过实时超声引导进行经皮穿刺。51.4%的患者采用解剖定位法进行穿刺。实时超声引导组的总体成功率为100%（n = 52），解剖定位置入组为96.4%（n = 53），（P = 0.496）。实时超声引导组首次经皮穿刺成功率为57.7%（n = 30），解剖定位置入组为45.5%（n = 25），（P = 0.460）。数据显示超声引导下CVC置入组的总体成功率和首次成功率较高，但差异无统计学意义。
