在大流行期间处于倾斜位置的中央静脉通道:叙述性回顾
Ferdinando Longo1, Francesca De Caris1, Alessandro Strumia1
1Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Lazio, Italy.
The journal of vascular access
|May 21, 2024
概括
管理危急病患者的中央静脉接入处置在易受伤害的位置,特别是在COVID-19大流行期间,提出了重大挑战. 这份综述强调了血管接入器件安置和维护在位患者中的困难,并强调了需要改进的协议的需要.
科学领域:
- 临界护理医学 临界护理医学
- 血管接入 血管接入
- 传染病流行病学 传染病流行病学
背景情况:
- 由于COVID-19大流行,需要在重症监护室 (ICU) 进行机械通风.
- 中枢静脉接入对于向重症患者提供治疗至关重要.
- 倾斜的位置为中央静脉导管插入和维护带来了独特的挑战.
研究的目的:
- 审查在COVID-19大流行期间在易受影响的位置管理的患者建立和维护中央静脉通道的挑战和策略.
- 综合现有的关于在非传统患者位置上插入血管接入装置 (VAD) 的文献.
主要方法:
- 对病例报告,病例系列和信件的文献综述,重点关注易受感染患者的中枢静脉通道.
- 分析与患者定位,设备选择和解剖学变异有关的挑战.
主要成果:
- 有限的流行前数据存在于VAD插入容易的位置.
- 疫情期间,报告中详细介绍了VAD安置,功能故障和pronation期间错位的困难.
- 尽管技术复杂,但通过内,手臂,大腿和骨静脉成功实现了管.
结论:
- 管理易受感染的患者的中央静脉通道是复杂的,需要仔细的患者选择和适当的设备选择.
- 标准化协议和进一步的研究,包括随机对照试验,对于优化流行病和非流行病情景的技术至关重要.
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