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Korean J Crit Care Med > Volume 20(2); 2005 > Article
Korean Journal of Critical Care Medicine 2005;20(2): 159-164.
원저 : 소아 심혈관 수술환자에서 24-게이지 말초혈관 카테타를 이용한 쇄골하중심정맥 천자
김진모, 장영호, 박재홍
계명대학교 의과대학 마취통증의학교실
Subclavian Vein Catheterization by Using 24-Gauge Peripheral Angiocatheter in Pediatric Cadiovascular Surgical Patients
Jin Mo Kim, Young Ho Jang, Jae Hong Park
Department of Anesthesioloy and Pain Medicine, Keimyung University School of Medicine, Daegu, Korea. kimjin00@dsmc.or.kr
BACKGROUND: Central venous catheterization (CVP) often leads to unacceptable complications, especially in pediatrics. To reduce these complications, we modified the venipucture by using 24-gauge peripheral angiocatheter (24-AG) in pediatric patients. METHODS: A 24-AG attached to a 3 cc syringe instead of a thin-wall steel needle in the commercial CVP kit was inserted and advanced in the direction of the inmominate vein with 45degrees angle. When blood was observed in the syrige, the 24-AG was more advanced into the subclavian vein and the 24-AG stylet was removed. A J-guide wire was inserted through lumen of the angiocather. The following procedure was the same as the Sheldinger technique. RESULTS: 202 pediatric patients received subclavian venipuncture by the method mentioned above. The overall success rate was 96.5%. The rate of success for the first attempt was 85.6% and the average number of venipuncture was 1.3+/-0.1. The overall complications was 6.4%, including hematoma formation (1.5%), pneumothorax (1.5%), bleeding at the puncture site (1.0%), mild hemothorax (0.5%) and pleural puncture without pneumothorax (2.0%). CONCLUSIONS: The subclavian venepuncture by using 24-gauge peripheral angiocatheter was reliable and useful technique in pediatric patients. The overall complications by this method was reduced compared to other reports.
Key Words: Angiocatheter; Complications; CVP; Pediatrics
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