Boulet Nicolas, Muller Laurent, Rickard Claire M, Lefrant Jean-Yves, Roger Claire
Department of Anesthesiology, Critical Care, Intensive Care, Pain and Emergency Medicine, Nîmes University Hospital, Place du Professeur Debré, Gard, 30900, Nîmes, France.
IMAGINE, UR-UM 103, University of Montpellier, Nîmes University Hospital, Nîmes, France.
Ann Intensive Care. 2023 May 25;13(1):46. doi: 10.1186/s13613-023-01141-w.
Central venous catheterization (CVC) is a frequent procedure, practiced by intensivists, anesthesiologists and advanced practice nurses in intensive care units and operative rooms. To reduce CVC-associated morbidity, it is essential to strive for best practices, based on the latest evidence. This narrative review aims to synthesize current knowledge on evidence-based best practices for CVC that improve the use and feasibility of real-time ultrasound-guided insertion procedures. Optimization of the vein puncture technique and the development of new technologies are discussed to reinforce the use of the subclavian vein catheterization as first choice. The search for alternative site of insertions, without increasing infectious and thrombotic risks, deserves further research.
中心静脉置管（CVC）是一种常见的操作，重症监护病房和手术室的重症医学专家、麻醉医生及高级执业护士都会进行。为降低与CVC相关的发病率，依据最新证据努力践行最佳实践至关重要。本叙述性综述旨在综合当前关于CVC循证最佳实践的知识，以提高实时超声引导下置管操作的应用和可行性。讨论了静脉穿刺技术的优化及新技术的开发，以加强将锁骨下静脉置管作为首选的应用。在不增加感染和血栓形成风险的情况下寻找替代置管部位值得进一步研究。
