PDF(Pubmed)
Abstract：
Peripherally inserted central catheter (PICC) placement under real-time ultrasound guidance has emerged as a favorable procedure in children as a method to efficiently obtain central access. Nevertheless, small infants with hemodynamic instability are at high risk of complications and extra precautions are necessary. We present a case of an inadvertent arterial placement of a PICC in a two-month-old infant with dilated cardiomyopathy and decompensated heart failure. Differentiation of arteries and veins under ultrasonographic evaluation may sometimes be difficult when the applied tourniquet pressure exceeds the patient\'s arterial blood pressure. In particular, arterial flow can be easily compromised by applying tourniquet pressure in small children with low blood pressure. A thorough understanding of the upper extremity vascular anatomy, basic scanning techniques, and meticulous preparation especially in small infants with hemodynamic instability are essential for maintaining the safety and efficacy of this procedure.
摘要：
实时超声引导下的外周插入中心导管（PICC）放置已成为儿童有效获得中心通道的一种有利方法。然而，血流动力学不稳定的小婴儿有很高的并发症风险,需要额外的预防措施.我们介绍了一例在两个月大的扩张型心肌病和失代偿性心力衰竭婴儿中意外动脉放置PICC的情况。当施加的止血带压力超过患者的动脉血压时，在超声检查下区分动脉和静脉有时可能很困难。特别是,对低血压的小孩施加止血带压力很容易损害动脉流量。深入了解上肢血管解剖，基本的扫描技术，特别是对于血流动力学不稳定的小婴儿，细致的准备对于维持该程序的安全性和有效性至关重要。
