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Arterielle und zentralvenöse Katheter bei Neugeborenen und Säuglingen

Arterial and central venous catheters in neonates and infants

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Zusammenfassung

Bei Neugeborenen und Säuglingen ermöglichen arterielle und zentralvenöse Katheter eine optimale perioperative Überwachung und intensivmedizinische Betreuung. Bei Neugeborenen ist das Einlegen von Nabelvenen- und Nabelarterienkathetern in den ersten Lebenstagen meist einfach und komplikationslos. Wie bei anderen zentral gelegenen Kathetern ist auch hier auf eine korrekte Position zu achten. Die Liegedauer dieser Katheter sollte 5–7 Tage nicht überschreiten. Die von peripher eingeführten zentralvenösen Silastic-Katheter werden bei Neugeborenen häufig verwendet und stellen auch bei Säuglingen eine Alternative zu den üblichen zentralvenösen Leitungen dar. Um schwer wiegende Komplikationen (z. B. Perikardtamponade, Infusothorax) zu vermeiden, müssen Fehllagen unbedingt zuverlässig ausgeschlossen werden. Chirurgisch eingelegte Broviac-Katheter können bei Langzeitbedarf eines zentralvenösen Zugangs zur Anwendung kommen. Durch striktes Einhalten von gewissen Regeln bei Einlage und Handhabung von zentralvenösen Kathetern kann das Risiko einer Kathetersepsis deutlich reduziert werden.

Abstract

In neonates and infants, arterial and central venous catheters are of vital importance to optimize perioperative surveillance during surgery as well as postoperative care in the intensive care unit. The insertion of umbilical venous (UVC) and umbilical arterial catheters (UAC) in neonates in the first days of life is relatively simple and associated with a low procedure-related risk. As with other centrally placed catheters, correct positioning must be verified and the catheters should not be used for more than 5–7 days. Peripherally inserted central catheters (PICC) are commonly used in neonates and can be an alternative to conventional central venous lines in older infants. In order to minimize the risk associated with catheter malposition, correct position must always be verified by appropriate imaging studies or ECG guidance. Surgically placed Broviac catheters are mainly used in patients with a long-term need for central venous access. Finally, it has been shown that adherence to strict guidelines for insertion and handling can significantly reduce catheter-associated infections.

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  1. Neonatologische und pädiatrische Intensivpflegestation, Kinderspital, 6000, Luzern, Schweiz

    M. Stocker &  T. M. Berger

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  1. M. Stocker
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  2. T. M. Berger
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Correspondence to T. M. Berger.

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Stocker, M., Berger, T.M. Arterielle und zentralvenöse Katheter bei Neugeborenen und Säuglingen. Anaesthesist 55, 873–882 (2006). https://doi.org/10.1007/s00101-006-1052-1

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