Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Easy and Safe Catheterization of the Innominate Vein

무명정맥의 쉽고 안전한 삽관

  • 이흥섭 (인제대학교 의과대학 흉부외과학 교실) ;
  • 조창욱 (인제대학교 의과대학 흉부외과학 교실)
  • Published : 1996.12.01
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Abstract

Central venous line insertion is an essential procedure in a cardiac operation. For this, percuteneous Insertion is usually done in the internal jugular vein or the subclavian vein. However, this method can create such complications as pneumothorax and hemothorax, and repeated failure in inserting the cathet r, especially in infant and child patients, can waste excessive time. Consequently, in our hospital, catheterization of the innominate vein was done after the completion of sternotomy in the cardiac operation of infant and child patients weighing under 1 Okg. During operation, the catheter was placed in the left atrium through the foramen ovate or pulmonary artery to be used for pressure monitoring. When the patient's hemodynamic became stabilized, the catheter was withdrawn to either the right atrium or superior vena casa to be used as the channel for fluid replacement or drug administration. In our hospital, this procedure has been used in 96 cases since 1989. No complications such as pneumothorax and hemothorax occilrred, and neither bleeding after the removal of the catheter was seen.

심장수술시 중심 정맥 상관은 필수적으로 시행해야 하는 수기 중 하나이다. 보통은 내경 정 맥이나 쇄골 하정맥에 경피적 상관을 하는데 기흉이나 혈흉 등의 합병증을 유발할 수 있고,영유아의 경우는 반복된 상관실패로 많은 시간을 허비할 수 있다. 그래서 저자들은 몸무게 10kg이하의 영유아 개심술시 홍골절개가 완료된 상태에서 무명정맥을 노출하여 여기에 삽관을 한다. 술후 중환자실에서 이 무명정맥관은 주로 좌심방이나 폐동맥의 압력을 측정하는데 이용하고 관자가 혈역학적으로 안정되면 우심방이나 상대정맥으로 후퇴시켜 수액보급이나 약물투척 경로로 이용한다. 본원에서는 1989년 이후로 96예에서 시행하여 왔으며 이 삽관술로 인한 기흉이라 혈흉은 없었고 정맥관제거시 출혈에 의한 합병증도 경험하지 않았다.

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References

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