Murat ANIL, Ayşe Berna ANIL, Alkan BAL, Önder YAVAŞCAN, Berat KANAR, Nejat AKSU, Mehmet HELVACI, Esin ALBUDAK

Çocuk yoğun bakım biriminde santral venöz kateterizasyon komplikasyonlarının değerlendirilmesi

Amaç: Santral venöz kateter yerleştirilmesi yoğun bakım birimlerinde sık kullanılan bir yöntemdir. Bu çalışmada çocuk yoğun bakım biriminde santral venöz kateter yerleştirilmesi ile ilişkili komplikasyonların ve bu komplikasyonlara yol açabilecek risk etmenlerinin değerlendirilmeleri amaçlanmıştır. Gereç ve Yöntem: 01.07.2007-01.08.2009 tarihleri arasında İzmir Tepecik Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Klinikleri’nde Tıbbi-Cerrahi Çocuk Yoğun Bakım Birimi’ne yatan ve santral venöz kateter yerleştirilen 110 hasta (ortalama yaş: 46,9±54,5 ay; ortanca yaş: 21 ay; dağılım 228 ay-1 ay: 49 kız /61 erkek) çalışmaya alındı. Bulgular: Tüm olgulara toplam 128 [88 (%68,8) femoral, 37 (%28,9) subklaviyen ve üç (%2,3) juguler] kateter yerleştirilmişdi. Kateter yerleştirilmesi sırasında altı komplikasyon (%4,7), izlem sırasında ise 12 enfeksiyon (%9,4), altı tromboz (%4,7) ve iki (%1,6) kaza ile yerinden çıkma görülmüştür. Kateter yerleştirme işlemi sırasında görülen komplikasyonlarla ilişkili herhangi bir risk etmenine rastlanmamıştır (p>0,05). Femoral ve subklaviyen kateter yerleştirilen olgular arasında komplikasyonlar açısından bir fark bulunmamıştır (p>0,05). Çıkarımlar: Çocuk yoğun bakım birimlerinde santral venöz kateter yerleştirilmesi deneyimli ellerde güvenilir bir işlemdir. (Türk Ped Arfl 2011; 46:215-9)

The evaluation of central venous catheterization complications in a pediatric intensive care unit

Aim: Central venous catheter insertion is a procedure commonly used in intensive care units. In this study, the evaluation of complications related to central venous catheter is ation inserted in the pediatric intensive care unit and the risk factors associated with complications of central venous catheters are intended. Material and Method: Between 07.01.2007-08.01.2009, in Izmir Training and Research Hospital, Clinics of Pediatrics, Pediatric Medical-Surgical Intensive Care Unit, 110 patients with central venous catheters (mean age: 46.9±54.5 months, median age: 21 months, range 1 month-228 months: 49 female / 61 males) were studied. Results: A total of 128 catheters [femoral, subslavian and jugular catheters as 88 (68.8%), 37 (28.9%) and three (2.3%), respectively] were inserted in 110 patients. During catheter insertion, six insertion-related complications (4.7%) occured whereas 12 infections (9.4%), six thromboses (4.7%) and two (1.6%) accidental removals were observed during follow-up. No risk factors were observed for catheter insertion-related complications (p > 0.05). There was no significant difference in the risk of complications observed between the cases with subklavian and those with femoral catheterization (p>0.05). Conclusions: The placement of central venous catheters in pediatric intensive care unit is a safe procedure in experienced hands. (Turk Arch Ped 2011; 46: 215-9)

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