Usefulness of exchanging a tunneled central venous catheter using a subcutaneous fibrous sheath
Usefulness of exchanging a tunneled central venous catheter using a subcutaneous fibrous sheath
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DOI：
10.1016/j.nut.2010.05.005
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发表时间：
2011-05-01
期刊：
影响因子：
4.4
通讯作者：
Taguchi, Tomoaki
中科院分区：
文献类型：
--
作者：
Masumoto, Kouji;Esumi, Genshiro;Taguchi, Tomoaki
目的：保留中心静脉的静脉通路对于长期肠外营养（PN）至关重要。频繁的导管相关性血流感染（CRBSI）会导致静脉通路闭塞。因此，一种改良的交换程序，使用隧道中心静脉导管（CVC）与纤维鞘的开发，以保持路线的中央vein.Methods：7例患者谁需要长期PN收到了改良的交换程序和交换CVC的结果进行了回顾性reviewed.Results：该程序进行了10次在7例。所有患者的静脉途径均为锁骨下静脉或颈内静脉。在几乎所有患者中，导管的更换是由于CRBSI或闭塞。更换后使用新导管的平均持续时间为296.2天。4根导管继续使用，其余导管被取出。拔除原因为严重CRBSI和闭塞，各有2例导管插入患者发生，而拔除剩余导管的原因是患者不再需要导管。使用纤维鞘的改良导管交换，即使在CRBSI患者中，对于需要长期PN或其他治疗的患者，似乎是一种有效的保留中央静脉静脉途径的手术。(C)2011 Elsevier Inc. All rights reserved.
Objectives: The reserve of the venous route to the central veins is important for long-term parenteral nutrition (PN). Frequent catheter-related bloodstream infection (CRBSI) induces occlusion of the venous routes. Therefore, a modified exchange procedure using a tunneled central venous catheter (CVC) with a fibrous sheath was developed to preserve the route to the central veins.Methods: Seven patients who required long-term PN received the modified exchange procedure and the outcome of exchanged CVC was retrospectively reviewed.Results: The procedure was performed 10 times in seven patients. The venous routes were either the subclavicular or the internal jugular vein in all patients. The exchange of the catheter was due to CRBSI or occlusion in almost all patients. The mean duration of new catheter use was 296.2 days following the exchange. Four catheters continued to be used, and the remaining ones were removed. The reasons for removal were severe CRBSI and occlusion, each of which occurred in two catheterized patients, while the reason for removing the remaining catheters was because the patients no longer needed the catheters.Conclusion: The modified catheter exchange using fibrous sheath, even in patients with CRBSI, appears to be an effective procedure for reserving the venous route to the central veins in patients who require either long-term PN or other treatments. (C) 2011 Elsevier Inc. All rights reserved.