Research Article
Yoğun bakım ünitelerinde santral venöz kateter endikasyonları, komplikasyonları, avantaj ve dezavantajları
Abstract
Amaç: Bu çalışma ile yoğun bakım ünitelerinde uygulanan santral venöz kateterizasyon işlemlerinin endikasyon ve komplikasyon yönünden retrospektif olarak değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmamızda, 2016-2020 yılları arasında yoğun bakım ünitelerinde santral venöz kateter uygulanan 1285 hastanın demografik verileri, yoğun bakım üniteleri, girişim yeri, yatış tanıları ve komplikasyonları değerlendirildi.
Bulgular: Hastaların 526’sı (%40,9) kadın ve 759’u (%59) erkekti. Hastaların %77,5’sine juguler, %15,6’sına subklavyen ve %6,7’sine femoral venöz kateterizasyon uygulanmış, %2,6’sında (n=32) pnömotoraks, %1,8’inde (n=22) malpozisyon ve %3,3’ünde (n=43) enfeksiyon tespit edilmiştir.
Sonuç: Santral venöz kateterizasyon komplikasyonlarını önlemek amacıyla malpozisyonun ekarte edilmesi gerektiğini ve uzun süreli kullanımının (>7 gün) komplikasyonları artıracağını düşünmekteyiz.
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Thanks
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References
- Rebecca AS, Atilio B, Shahar BY, Jonathan BM. Cardiovascularmonitoring. In: Miller RD, ed. Anesthesia. VolI. ; 2009.
- McGee WT, Mailloux PT, Martin RT. Safeplacement of centralvenouscatheters: a measuredapproach: A measuredapproach. J IntensiveCareMed. 2011;26(6):392-396. doi:10.1177/0885066610392895
- Askegard-Giesmann JR, CanianoDA,Kenney BD. Rare but seriouscomplications of centrallineinsertion. Semin Pediatr Surg. 2009;18(2):73-83. doi:10.1053/j.sempedsurg.2009.02.003
- Polderman KH, Girbes AJ. Central venouscatheterusePart 1: MechanicalcomplicationsIntensiveCareMed. MechanicalcomplicationsIntensiveCareMed. 2002;1:1-17.
- Morgan GE, Mikhail MS, Murray MJ. PatientMonitors. ClinicalAnesthesiology. Vol 2018. McGraw-Hill
- Kuş S, Pempeci S, Argüder E, Karalezli A, Gündoğdu H, Hasanoğlu HC. Santral venöz kateter malpozisyonu ilişkili akciğer komplikasyonu. Turkiye Klinikleri ArchLung. 2018;19(1):26-29.
- Frykholm P, Pikwer A, Hammarskjöld F, et al. Clinicalguidelines on centralvenouscatheterisation. SwedishSociety of AnaesthesiologyandIntensiveCareMedicine: Central venouscatheterisation. ActaAnaesthesiolScand. 2014;58(5):508-524. doi:10.1111/aas.12295
- Pikwer A, Bååth L, Davidson B, Perstoft I, Akeson J. Theincidenceand risk of centralvenouscathetermalpositioning: a prospectivecohortstudy in 1619 patients. AnaesthIntensiveCare. 2008;36(1):30-37. doi:10.1177/0310057X0803600106
- Özmen H, Aydınlı B, Çitilcioğlu US, Özen A, Tekin K. Santral venöz kateterizasyon yapılan hastalarda kateter yerleştirme lokalizasyonu tercihi ve kateter malpozisyonlarının retrospektif İncelenmesi. GKDA Derg. 2020;26(2):95-101.
- Akdemir MS, Kılıç ET, Kılıç H, Altınel. Yoğun Bakım Ünitesinde Santral Venöz Kateter Deneyimlerimiz: Retrospektif Değerlendirme GKDA Derg. 2018;24(1):29-34.
- Santos FKY, Flumignan RLG, Areias LL, et al. Peripherallyinsertedcentralcatheterversuscentralvenouscatheterforintravenousaccess: A protocolforsystematicreviewand meta-analysis. Medicine (Baltimore). 2020;99(30):e20352. doi:10.1097/MD.0000000000020352
- McGee DC, Gould MK. Preventingcomplications of centralvenouscatheterization. N Engl J Med. 2003;348(12):1123-1133. doi:10.1056/NEJMra011883
- Tsotsolis N, Tsirgogianni K, Kioumis I, et al. Pneumothorax as a complication of centralvenouscatheterinsertion. Ann TranslMed. 2015;3(3):40. doi:10.3978/j.issn.2305-5839.2015.02.11
- Kusminsky RE. Complications of centralvenouscatheterization. J AmCollSurg. 2007;205(3):517. doi:10.1016/j.jamcollsurg.2007.04.015
- Ruesch S, Walder B, Tramer MR. Complications of centralvenouscatheters: internaljugularversussubclavanaccess -a systematicreview. CritCareMed. 2002;30:454-460.
- Hohlrieder M, Schubert HM, Biebl M, Kolbitsch C, Moser PL, Lorenz IH. Successfulaspiration of blooddoes not excludemalposition of a large-borecentralvenouscatheter. Can J Anaesth. 2004;51(1):89-90. doi:10.1007/bf03018557
- Schuster M, Nave H, Piepenbrock S, Pabst R, Panning B. Thecarina as a landmark in centralvenouscatheterplacement. Br J Anaesth. 2000;85(2):192-194. doi:10.1093/bja/85.2.192
- Stonelake PA, Bodenham AR. Thecarina as a radiologicallandmarkforcentralvenouscatheter tip position. Br J Anaesth. 2006;96(3):335-340. doi:10.1093/bja/aei310
- Chalkiadis GA, Goucke CR. Depth of centralvenouscatheterinsertion in adults: an auditandassessment of a techniquetoimprove tip position. AnaesthIntensiveCare. 1998;26(1):61-66. doi:10.1177/0310057X9802600109
- Jeon Y, Ryu HG, Yoon SZ, Kim JH, Bahk JH. Transesophagealechocardiographicevaluation of ECG-guidedcentralvenouscatheterplacement. Can J Anaesth. 2006;53(10):978-983. doi:10.1007/BF03022525
- AmericanSociety of AnesthesiologistsTask Force on Central Venous Access, Rupp SM, Apfelbaum JL, et al. Practiceguidelinesforcentralvenousaccess: a reportbytheAmericanSociety of AnesthesiologistsTask Force on Central Venous Access. Anesthesiology. 2012;116(3):539-573. doi:10.1097/ALN.0b013e31823c9569
- Yalçın AN. Kateter enfeksiyonları ve bakteriyemiler: Epidemiyoloji. Hastane İnfeksDerg. 2004;8:154-156.
- Bayraktar B, Borsa BA, Bulut E. Kateter ilişkili enfeksiyonlarda kateter uçlarından izole edilen mikroorganizmalar ve antibiyotiklere dirençleri. AnkemDerg.2007;21:46-49.
Indications, complications, advantages and disadvantages of central venous catheters in intensive care units
Abstract
Aim: In this study, it was aimed to assess central venous catheterization practices used in our intensive care units retrospectively.
Materials and Methods: 1285 patients who underwent central venous catheterization in intensive care units between the years of 2016-2020 were included in our study. Demographic information, intensive care units, sites of intervention, hospitalization diagnoses, and complications of patients were evaluated.
Results: Of the patients, 526 (40.9%) were women, while 759 (59%) were men. Jugular catheterization was performed in 77.5%, subclavian in 15.6% and femoral venous catheterization in 6.7% of the patients, pneumothorax was performed in 2.6% (n=32) and 1.8% (n= 22) malposition and infection in 3.3% (n=43).
Conclusion:We think that malposition should be excluded in order to prevent central venous catheterization complications and its long-term use (>7 days) will increase complications.
Project Number
yok
References
- Rebecca AS, Atilio B, Shahar BY, Jonathan BM. Cardiovascularmonitoring. In: Miller RD, ed. Anesthesia. VolI. ; 2009.
- McGee WT, Mailloux PT, Martin RT. Safeplacement of centralvenouscatheters: a measuredapproach: A measuredapproach. J IntensiveCareMed. 2011;26(6):392-396. doi:10.1177/0885066610392895
- Askegard-Giesmann JR, CanianoDA,Kenney BD. Rare but seriouscomplications of centrallineinsertion. Semin Pediatr Surg. 2009;18(2):73-83. doi:10.1053/j.sempedsurg.2009.02.003
- Polderman KH, Girbes AJ. Central venouscatheterusePart 1: MechanicalcomplicationsIntensiveCareMed. MechanicalcomplicationsIntensiveCareMed. 2002;1:1-17.
- Morgan GE, Mikhail MS, Murray MJ. PatientMonitors. ClinicalAnesthesiology. Vol 2018. McGraw-Hill
- Kuş S, Pempeci S, Argüder E, Karalezli A, Gündoğdu H, Hasanoğlu HC. Santral venöz kateter malpozisyonu ilişkili akciğer komplikasyonu. Turkiye Klinikleri ArchLung. 2018;19(1):26-29.
- Frykholm P, Pikwer A, Hammarskjöld F, et al. Clinicalguidelines on centralvenouscatheterisation. SwedishSociety of AnaesthesiologyandIntensiveCareMedicine: Central venouscatheterisation. ActaAnaesthesiolScand. 2014;58(5):508-524. doi:10.1111/aas.12295
- Pikwer A, Bååth L, Davidson B, Perstoft I, Akeson J. Theincidenceand risk of centralvenouscathetermalpositioning: a prospectivecohortstudy in 1619 patients. AnaesthIntensiveCare. 2008;36(1):30-37. doi:10.1177/0310057X0803600106
- Özmen H, Aydınlı B, Çitilcioğlu US, Özen A, Tekin K. Santral venöz kateterizasyon yapılan hastalarda kateter yerleştirme lokalizasyonu tercihi ve kateter malpozisyonlarının retrospektif İncelenmesi. GKDA Derg. 2020;26(2):95-101.
- Akdemir MS, Kılıç ET, Kılıç H, Altınel. Yoğun Bakım Ünitesinde Santral Venöz Kateter Deneyimlerimiz: Retrospektif Değerlendirme GKDA Derg. 2018;24(1):29-34.
- Santos FKY, Flumignan RLG, Areias LL, et al. Peripherallyinsertedcentralcatheterversuscentralvenouscatheterforintravenousaccess: A protocolforsystematicreviewand meta-analysis. Medicine (Baltimore). 2020;99(30):e20352. doi:10.1097/MD.0000000000020352
- McGee DC, Gould MK. Preventingcomplications of centralvenouscatheterization. N Engl J Med. 2003;348(12):1123-1133. doi:10.1056/NEJMra011883
- Tsotsolis N, Tsirgogianni K, Kioumis I, et al. Pneumothorax as a complication of centralvenouscatheterinsertion. Ann TranslMed. 2015;3(3):40. doi:10.3978/j.issn.2305-5839.2015.02.11
- Kusminsky RE. Complications of centralvenouscatheterization. J AmCollSurg. 2007;205(3):517. doi:10.1016/j.jamcollsurg.2007.04.015
- Ruesch S, Walder B, Tramer MR. Complications of centralvenouscatheters: internaljugularversussubclavanaccess -a systematicreview. CritCareMed. 2002;30:454-460.
- Hohlrieder M, Schubert HM, Biebl M, Kolbitsch C, Moser PL, Lorenz IH. Successfulaspiration of blooddoes not excludemalposition of a large-borecentralvenouscatheter. Can J Anaesth. 2004;51(1):89-90. doi:10.1007/bf03018557
- Schuster M, Nave H, Piepenbrock S, Pabst R, Panning B. Thecarina as a landmark in centralvenouscatheterplacement. Br J Anaesth. 2000;85(2):192-194. doi:10.1093/bja/85.2.192
- Stonelake PA, Bodenham AR. Thecarina as a radiologicallandmarkforcentralvenouscatheter tip position. Br J Anaesth. 2006;96(3):335-340. doi:10.1093/bja/aei310
- Chalkiadis GA, Goucke CR. Depth of centralvenouscatheterinsertion in adults: an auditandassessment of a techniquetoimprove tip position. AnaesthIntensiveCare. 1998;26(1):61-66. doi:10.1177/0310057X9802600109
- Jeon Y, Ryu HG, Yoon SZ, Kim JH, Bahk JH. Transesophagealechocardiographicevaluation of ECG-guidedcentralvenouscatheterplacement. Can J Anaesth. 2006;53(10):978-983. doi:10.1007/BF03022525
- AmericanSociety of AnesthesiologistsTask Force on Central Venous Access, Rupp SM, Apfelbaum JL, et al. Practiceguidelinesforcentralvenousaccess: a reportbytheAmericanSociety of AnesthesiologistsTask Force on Central Venous Access. Anesthesiology. 2012;116(3):539-573. doi:10.1097/ALN.0b013e31823c9569
- Yalçın AN. Kateter enfeksiyonları ve bakteriyemiler: Epidemiyoloji. Hastane İnfeksDerg. 2004;8:154-156.
- Bayraktar B, Borsa BA, Bulut E. Kateter ilişkili enfeksiyonlarda kateter uçlarından izole edilen mikroorganizmalar ve antibiyotiklere dirençleri. AnkemDerg.2007;21:46-49.
There are 23 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Cardiovascular Surgery |
| Journal Section | Research Article |
| Authors | |
| Project Number | yok |
| Early Pub Date | August 16, 2023 |
| Publication Date | August 30, 2023 |
| Submission Date | December 27, 2022 |
| Acceptance Date | June 12, 2023 |
| Published in Issue | Year 2023 Volume: 9 Issue: 2 |
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