Diferencia entre revisiones de «Central venous catheterization»
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*[[Pediatric central line]]
*[[Pediatric central line]]


==Contraindications==
{{Central line indications}}
{{Central line with coagulopathy}}
 
{{Central line contraindications}}


==See Also==
==See Also==

Revisión del 00:42 21 jun 2015

Types

Indications

  • Central venous pressure monitoring
  • Administration of multiple medications and drips
  • High volume/flow resuscitation[citation needed]
  • Emergency venous access
  • Inability to obtain peripheral venous access
  • Repetitive blood sampling
  • Administering hyperalimentation, vasopressors, caustic agents, or other concentrated fluids
  • Insertion of transvenous cardiac pacemakers
  • Hemodialysis or plasmapheresis
  • Insertion of pulmonary artery catheters

Contraindications

Absolute[1]

  • Infection over the placement site
  • Anatomic obstruction (thrombosis of target vein, other anatomic variance)
  • Site-specific
    • Subclavian - trauma/fracture to ipsilateral clavicle or proximal ribs

Relative

  • Coagulopathy (see below)
  • Distortion of landmarks by trauma or congenital anomalies
  • Prior vessel injury or procedures
  • Morbid obesity
  • Uncooperative/combative patient

Central line if coagulopathic

  • Preferentially use a compressible site such as the femoral location (avoid the IJ and subclavian if possible, though IJ preferred over subclavian)
  • No benefit to giving FFP unless artery is punctured[2]

See Also

Source

  1. ↑ Graham, A.S., et al. Central Venous Catheterization. N Engl J Med 2007;356:e21
  2. ↑ Fisher NC, Mutimer DJ. Central venous cannulation in patients with liver disease and coagulopathy—a prospective audit. Intens Care Med 1999; 25:5
  3. ↑ Morado M.et al. Complications of central venous catheters in patients with haemophilia and inhibitors. Haemophilia 2001; 7:551–556
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