大腿静脈穿刺IVHは勧められない


2011年4月血管内カテーテル由来感染予防のＣＤＣガイドライン
・ 成人患者では中心静脈アクセスに大腿静脈を使用することを避ける[38, 50, 51, 54]

・成人患者では頚または大腿ではなく鎖骨下を挿入部位にする[50-52]

・大腿カテーテルは内頚カテーテルまたは鎖骨下カテーテルより深部静脈血栓症のリスクが高いため、できる限り大腿カテーテルも避けるべきである[48-50, 53, 247]

・ 血液透析患者及び進行腎疾患患者では鎖骨下静脈狭窄を防ぐために鎖骨下部位を避ける[53, 55-58]

・カテーテルの再挿入の回数や機械的合併症を低減するために超音波ガイド下に中心静脈カテーテルを留置する（この方法が利用可能な場合）。超音波ガイド下留置は充分な訓練を受けてから行うべきである。[60-64]

・内頚静脈に挿入したカテーテルは鎖骨下静脈に挿入したカテーテルより全般的に細菌定着または CRBSI のリスクが高かった[37-47]
※カテーテル関連血流感染（CRBSI）［catheter related blood stream infection］
私見）
IVHはベッドサイドではやらんほうがええということか？
CDCのガイドラインに従わないで気胸など合併症を起こしたら訴訟問題に発展するのだろうか？
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