| Autor: |
KARELLAS, J., TSAKALAKIS, Chr., ARSENOGLOU, A., SOURLAS, S., LIAPIS, G. |
| Zdroj: |
Balkan Military Medical Review; 2013 Supplement, Vol. 16, p263-264, 2p |
| Abstrakt: |
PURPOSE: The purpose of the study was to assess the safety and the effectiveness of the insertion of a subclavian central venous catheter. Subclavian vein catheterization has low rates of infections or thrombosis but can also have life threatening complications. MATERIALS and METHOD‟s: In a prospective and randomised study, 148 patients receiving anticoagulation therapy, had a central venous catheterization with the Seldinger technique. A subclavian vein was selected and 6 cannulation attempts were allowed. Each puncture with a 18 gauge needle was considered as an attempt. Failure to cannulate the subclavian vein directed the efforts to the ipsilateral internal jugular vein and six cannulation attempts were also allowed before the use of ultrasound guidance. A chest film was obtained after each catheterization. RESULT‟s: The catheterization of the subclavian vein was successful in 137 patients (93%, 73 patients 1-3 attempts, 64 patients 4-6 attempts). In 8 cases (5%) subclavian vein could not be accessed and the internal jugular vein was cannulated. Ultrasound guidance was used in 3 occasions (2%). None of the patients had pneumothorax, hemothorax, excessive hemorrhage or haematoma. In 3 cases there was an arterial puncture. In 2 cases there was misplacement of the catheter to the contralateral subclavian vein. In 15 cases there was difficulty to pass the dilator over the guidewire. Minor bleeding was encountered in 5 cases. CONCLUSION: Subclavian vein can be safely and effectively catheterized and should be the preferred site for central vein cannulation unless contraindicated. Ultrasound guidance should not be used as a routine but only as a last resort. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
