在儿童中用于中央静脉导管尖端定位的跨胸腔心声学:使用跨食道心声学作为参考方法的观察性研究
Kristen K Thomsen1,2, Michael Fritz1, Christian Zöllner1
1Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Paediatric anaesthesia
|January 4, 2025
概括
胸外心声学 (TTE) 在91%的儿科患者中成功引导了中央静脉导管 (CVC) 尖端的放置,确保了在心腔结处的最佳定位. 这种方法在年幼的儿童中特别有效,提高了重症监护期间的CVC安全性.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 心血管成像 - 心血管成像
- 干预性心脏病学 干预性心脏病学
背景情况:
- 中枢静脉导管 (CVC) 插入对于重症儿童至关重要,但需要精确地将尖端放置在心腔结处,以防止并发症.
- 胸外心电回声 (TTE) 是确认心血管中心尖端位置的潜在工具,但其准确性因与胸部X射线进行比较而受到限制,因为胸部X射线无法直接可视化心腔腔结.
研究的目的:
- 评估TTE在指导CVC尖端在儿科患者的插入过程中精确定位的有效性.
- 测试TTE引导的CVC放置在至少90%的病例中实现正确定位的假设,经过食道心声学 (TEE) 验证.
主要方法:
- 一项前性观察性研究,涉及150名儿童 (0-14岁) 因先天性心脏病接受选择性手术.
- 使用TTE来指导CVC尖端的放置,最终的位置被TEE确认为参考标准.
主要成果:
- 在150名儿童中,TTE指导在136名儿童中 (91%准确率) 导致了正确的CVC尖端定位在心腔结处.
- 准确度在0-3个月的婴儿中最高 (96%),在13-14岁的青少年中最低 (70%).
结论:
- 对于儿科患者来说,TTE引导的CVC尖端定位是非常准确的 (91%),由TEE证实.
- 在儿童中,特别是年龄较小的儿童中,TTE是确保正确的CVC尖端放置的宝贵工具.
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