关注ICU患者PICC导管.PDFVIP

关注ICU患者的PICC导管 重症医学科神经ICU 陶艳  Paolo Cotogni, Anesthesiology and Intensive Care, Department of Medicine, S. Giovanni Battista Hospital, University of Turin, 10123 Turin, Italy  Mauro Pittiruti, Department of Surgery, Catholic University Hospital, 00168 Rome, Italy  World Journal of Critical Care Medicine 2014 November 4; 3(4): 80 -94  Venous access devices are pivotal  静脉通路是越来越多的重症病人 importance for an increasing number of 及各种疾病和各种临床科室(急诊, critically ill patients in a variety of disease states and in a variety of clinical settings 重症监护,手术)或是针对不同目 (emergency, intensive care, surgery) and for 的(液体或药物输液、注射用抗生 different purposes (fluids or drugs infusions, 素治疗、血流动力学监测、透析) parenteral nutrition, antibiotic therapy, 的关键手段。 hemodynamic monitoring, procedures of dialysis/apheresis).  However, healthcare professionals are  然而，医疗保健专业人士普遍担 commonly worried about the possible 心使用中心静脉设备（CVAD） consequences that may result using a central 可能造成的后果（主要是血液感 venous access device (CVAD) (mainly, bloodstream infections and thrombosis), 染，和血栓形成），不论经外周 both peripherally inserted central catheters 静脉置入中心静脉导管（PICC） (PICCs) and centrally inserted central 和集中插入中心静脉导管 （ catheters (CICCs). This review aims to CICCs）。本文旨在讨论PICC适 discuss indications, insertion techniques, 应症，置管技术，在危重病患者 and care of PICCs in critically ill patients. 的护理。  PICCs have many advantages over  同标准的cvc比较PICC有许多优点， standard CICCs. First of all, their insertion 首先，导管置入更容易更安全，因 is easy and safe -due to their placement 其位置在手臂外周静脉并且其导管 into peripheral veins of the arm-and the advantage of a central location of catheter 尖端的中心位置适合所有摩尔渗透 tip suitable for all osmolarity and pH 压浓度和pH值的优势，在超声引 solutions , Using t