Gawda Ryszard, Czarnik Tomasz
Department of Anesthesiology and Intensive Care, Institute of Medical Sciences, University of Opole, Opole, Poland.
J Vasc Access. 2025 May 1:11297298251334890. doi: 10.1177/11297298251334890.
Percutaneous arterial cannulation for arterial catheter placement is a commonly performed procedure in intensive care. In many cases routinely cannulated radial arteries may be inaccessible because of shock, arteriosclerosis, or vasoconstriction. In this scenario, femoral or axillary artery may be chosen for arterial catheter placement. Percutaneous cannulation of the axillary artery via the infraclavicular route has two main advantages over cannulation of the femoral artery: avoidance of cannulation of the artery affected by arteriosclerosis and microbiological safety by avoiding cannulation in the inguinal area. This paper describes ultrasound-guided, real-time infraclavicular cannulation of the axillary artery for arterial catheter placement in critically ill patients. The cannulation technique is described in a step-by-step manner. In addition, the limitations of this arterial approach are presented together with the indications and contraindications. The pitfalls that are likely to occur during cannulation via the infraclavicular route are also reviewed.
经皮动脉插管放置动脉导管是重症监护中常用的操作。在许多情况下，由于休克、动脉硬化或血管收缩，常规插管的桡动脉可能无法触及。在这种情况下，可选择股动脉或腋动脉进行动脉导管放置。经锁骨下途径经皮穿刺腋动脉与股动脉插管相比有两个主要优点：避免插管受动脉硬化影响的动脉，以及通过避免在腹股沟区插管实现微生物学安全。本文描述了在重症患者中超声引导下实时经锁骨下穿刺腋动脉放置动脉导管的方法。插管技术按步骤进行了描述。此外，还介绍了这种动脉入路的局限性以及适应证和禁忌证。还回顾了经锁骨下途径插管过程中可能出现的陷阱。
