Chait P G, Ingram J, Phillips-Gordon C, Farrell H, Kuhn C
Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Radiology. 1995 Dec;197(3):775-8. doi: 10.1148/radiology.197.3.7480755.
To assess the feasibility and complications of peripherally inserted central catheters (PICCs) in pediatric patients.
The authors attempted to place PICCs in 122 patients aged 9 days to 19 years (mean, 6.82 years; median, 5 years). Catheters were placed to allow prolonged administration of antibiotics or chemotherapeutic agents (n = 50), provide total parenteral nutrition (n = 41), and establish prolonged intravenous access for blood draws and fluid administration (n = 31). Silicone catheters measuring 3, 4, and 5 F were inserted in either basilic or cephalic veins and positioned at the junction of the superior vena cava and right atrium under fluoroscopic guidance. Patients were monitored for complications until devices were removed.
Fluoroscopically guided PICC placement was successful in 137 of 148 attempts. Postinsertion complications included mechanical defects of the catheter, PICC-related infection, occlusion of the PICC, and venous stasis. Complications occurred at a rate comparable to those seen with blind insertion.
Fluoroscopically guided PICC placement is feasible and safe in pediatric patients.
评估外周静脉穿刺中心静脉导管（PICC）在儿科患者中的可行性及并发症。
作者尝试为122例年龄在9天至19岁（平均6.82岁；中位数5岁）的患者置入PICC。置入导管用于长期输注抗生素或化疗药物（n = 50）、提供全胃肠外营养（n = 41）以及建立长期静脉通路用于采血和输液（n = 31）。将3F、4F和5F的硅胶导管插入贵要静脉或头静脉，并在透视引导下置于上腔静脉与右心房交界处。对患者进行并发症监测直至拔除导管。
148次尝试中，137次在透视引导下成功置入PICC。置管后并发症包括导管机械性缺陷、PICC相关感染、PICC堵塞和静脉淤滞。并发症发生率与盲目置管所见相当。
透视引导下为儿科患者置入PICC是可行且安全的。
