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1、ThenewenglandjournalofmedicinevideosinclinicalmedicinesummarypointsPICCPlacementintheNeonateAmyS.McCay,N.N.P.-B.C.,ElizabethC.Elliott,N.N.P.-B.C.,andMarleneWalden,Ph.D.,N.N.P.-B.C.Thefollowingtextsummarizesinformationprovidedinthevideo.OverviewNeonatalpatientsoftenrequirelong-term
2、vascularaccessforthedeliveryoflife-FromTexasChildren’sHospital,Houston.sustainingmedicationsandnutrition.TheperipherallyinsertedcentralcatheterAddressreprintrequeststoMs.McCayatTexasChildren’sHospital,6621Fannin(PICC)offersseveraladvantagesoverotherdevicesusedtoprovidecentralvascu
3、larSt.,Houston,TX77030,oratasmccay@accessinneonates.AneonatalPICCcanbeinsertedatthepatient’sbedsidewithcomcast.net.theuseofananalgesicagentandradiographicverification,anditcanremaininNEnglJMed2014;370:e17.placeforseveralweeksormonths.ThesmalldiameterofitslumenisidealfortheDOI:10.1
4、056/NEJMvcm1101914Copyright©2014MassachusettsMedicalSociety.extremelysmallneonate.TheneonatalPICChasatipthatterminatesatorclosetotheheartorinoneofthegreatvessels—thesuperiorvenacavaortheinferiorvenacava(Fig.1).IndicationsEarlyidentificationofpatientswhorequirelong-termvascularacce
5、ssandearlycentral-catheterplacementdecreasesthenumberofskinpuncturesandincreasesthesuccessrateofneonatalPICCplacement.CandidatesforaneonatalPICCincludeinfantswithverylowbirthweightwhorequirecontinuousparenteralnutrition,in-fantswhorequirelong-termintravenousaccess,infantswhorequir
6、etheinfusionoffluidsormedicationsthathavehyperosmolarorirritatingproperties,infantswhoneedadedicatedcathetertodeliveracriticalinfusionoflife-sustainingmedication,andinfantsinwhomperipheralaccesscannotbeachievedormaintained.1Figure1.NeonatalPeripherallyInsertedCentralCatheter,withT
7、ipContraindicationsTerminatingintheSuperiorVenaCava.Ingeneral,therearefewcontraindicationsforneonatalPICCplacement.Centralcathetersareoftennecessaryasa“lifeline”forthepatient.However,therearecer-taincircumstancesinwhichacentralcathetershouldbeavoidedifpossible.Theseincludesituatio
8、nsinwhichthereisanactivebloodstre
