Résumé
La pose de voie veineuse est l’un des actes de soins les plus couramment pratiqués. Le cathétérisme veineux périphérique sous échographie s’est développé ces dernières années dans la prise en charge de l’accès veineux difficile. L’examen échographique préalable est un facteur essentiel du succès de la technique. Il détermine la possibilité ou l’impossibilité de cathétérisme périphérique par la présence ou l’absence d’une veine éligible. Il recueille le diamètre de la veine cible et sa distance à la peau, permettant le choix du matériel. L’emploi de cathéters courts conventionnels est souvent inadapté et source d’échec précoce par diffusion de la perfusion. L’utilisation de cathéters longs semble pertinente mais cette technique reste encore marginale. Les conditions précises du cathétérisme veineux périphérique sous échographie restent à définir. La formation du personnel paramédical est probablement à développer.
Abstract
Insertion of intravenous catheters is widely performed in the hospital, especially in the emergency departments and intensive care units. While peripheral placement is the most common access, central venous catheters are used in case of peripheral cannulation failure. Ultrasound guidance may be helpful to determine the adequate catheter diameter and length as well as the adequate vein to catheterize. The use of long catheters seems more relevant but the technique remains marginal. Ultrasound guidance for peripheral intravenous placement using long catheters is of interest when difficult venous insertion is predictable. Further studies have to define protocols of peripheral cannulation and assess nurse training.
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Cronier, P., Meyer, P., Chevrel, G. et al. Perfusion veineuse périphérique difficile : apport de l’échographie. Réanimation 23, 533–539 (2014). https://doi.org/10.1007/s13546-014-0908-7
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DOI: https://doi.org/10.1007/s13546-014-0908-7