Verda TOPRAK, İsmet TOPÇU, Tezcan Gönül KELEŞ

İnfantlarda santral venöz kateterizasyon deneyimlerimiz

Amaç: İnfant olgulara uygulanan santral venöz kateterizasyon (SVK) işleminin özellikleri, kateterin takılması ve çekilmesine kadar geçen süreçte, karşılaşılan sorunların retrospektif olarak incelenmesi ve sonuçların literatür eşliğinde tartışılması amaçlandı. Yöntem: Mart 2004 ve Mayıs 2005 tarihleri arasında hastanemizde nonkardiyak cerrahi sonrası ve Pediatri Yoğun Bakım Ünitesi'nde izlenmek üzere 27 infantta uzman anesteziyologlar tarafından gerçekleştirilen SVK uygulamaları retrospektif olarak demografik veri, primer hastalık, girişim yeri ve gelişen komplikasyonlar açısından değerlendirildi. Bulgular: Olguların 13'ü (%48.1) 6 aydan küçük, 14'ü (%51.9) 6 aydan büyük infantlardı. 16'sı (%59.3) kız ve 11'i (%40.7) erkekti. SVK, 15 olguda (%55.6) internal juguler vene, 12 olguda (%44.4) subklavyen venden gerçekleştirilmişti. Kateter kalış süresi ortalama 5.9±5.2 gündü. Olguların 3'ünde (%11.1) kateterizasyon sırasında arter ponksiyonu yapılmıştı. Arter ponksiyonu ile kateter takılma yeri ve yaş arasında bir ilişki saptanmadı (p>0.05). Kateterden kan örneği alınabilmesi 15 (%55.6) infantta sağlanabildi. Kateter takılma yeri ve kan aspire edilebilme arasında istatistiksel ilişki saptanmadı (p>0.05). Sonuç: Pediatrik hastalarda SVK ile ilişkili komplikasyonlar yaş, vücut boyutu ve uygulayıcının deneyimi ile yakından ilişkilidir. Optimal yerleştirme bölgesi uygulayıcının deneyimine ve olgunun klinik durumuna bağlıdır.

Anahtar Kelimeler:

Geriyedönük çalışma, Kateterizasyon, santral venöz, Süt çocuğu, Juguler venler, Subklavian ven

A summary of cases of central venous catheterization in infants

Objective: The purpose of this study is to analyze the features of central venous catheterization (CVC) procedures, retrospective evaluation of the problems observed during catheter insertion up until its withdrawal of them and discuss the results according to the literature in infant cases. Method: Between March 2004 and May 2005, central venous catheters administered to 27 infants by consultant anesthesiologists for follow-up in non-cardiac surgery and Pediatric Intensive Care Unit were evaluated retrospectively with demographic data, primary disease, the place of catheterization and complications. Results: Thirteen of the cases (48.1%) were younger than 6 months and the rest (51.9%) were older than 6 months. Sixteen of the infants (59.3%) were female and 11 (40.7%) were male. Fifteen CVC (55.6%) were administered into the internal jugular vein and 12 (44.4%) into the subclavian vein. The mean catheterization time was 5.9+5.2 days. Arterial punctures during catheterization were observed in 3 of the cases (11.1%). There was no relationship between arterial puncture and the place of catheterization or the age of infants. Blood could be aspirated in 15 (55.6%) of the infants. There was no relationship between administration site and blood aspiration (p>0.05). Conclusion: In pediatric patients, the complications of CVCs are closely related to age, body size and the experience of the anesthesiologist. The optimum administration place depends on the experience of the anesthesiologist and the clinical condition of the case.

Keywords:

Retrospective Studies, Catheterization, Central Venous, Infant, Jugular Veins, Subclavian Vein,

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