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Anästhesiol Intensivmed Notfallmed Schmerzther 2002; 37(12): 757-761
DOI: 10.1055/s-2002-35913
Der besondere Beitrag
© Georg Thieme Verlag Stuttgart · New York

Aseptischer Wechsel des zentralen Venenkatheters über einen Führungsdraht

Aseptic Central Venous Catheter Exchange with a Guide WireM.  Przemeck1 , T.  Schürholz1 , B.  Vangerow2 , S.  Piepenbrock1
  • 1Abteilung Anästhesiologie I, Medizinische Hochschule Hannover
  • 2Lilly Deutschland GmbH, Bad Homburg
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Publication History

Publication Date:
05 December 2002 (online)

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Zusammenfassung

Der Wechsel zentralvenöser Katheter (ZVK) bei Intensivpatienten erfolgt bei Katheterdysfunktion, katheterassoziierter Sepsis, oder wenn ein anderer Kathetertyp erforderlich wird. Dieser kann durch Neupunktion oder durch Wechsel über einen Führungsdraht erfolgen. Bei mechanischen Katheterdefekten oder bei Wechseln des Kathetertyps wird der Wechsel über Draht empfohlen. Zu den Kontraindikationen gehören der Katheterinfekt und die infizierte Kathetereinstichstelle. In der Literatur finden sich nur wenige Hinweise auf das exakte aseptische Vorgehen bei einem derartigen ZVK-Wechsel, das wegen der unmittelbaren Nähe von kontaminiertem und sterilem Material problematisch ist. Wir beschreiben das in unserer Abteilung etablierte Verfahren, mit dem der ZVK-Wechsel mit Führungsdraht mit minimiertem Risiko einer Kreuzkontamination durch das entfernte Kathetermaterial erfolgen kann.

Abstract

Central venous catheters are exchanged in cases of malfunction, suspected infections, or when another catheter type is required. It can be replaced by new venipuncture or using a guide wire. The guide wire technique should be used with a defective catheter or when the catheter type is to be changed. It is contraindicated at exit site infections or proven or suspected catheter infections. Due to possible cross contamination of new by old catheter material meticulous aseptic technique is required. A detailed description of the process of catheter exchange using a guide wire with special regard to the aseptic technique is given.

Schlüsselwörter

Zentraler Venenkatheter - Katheterwechsel - Führungsdraht - Kreuzkontamination - Asepsis

Key words

Central venous catheter - catheter exchange - guide wire - cross contamination - asepsis

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Dr. Michael Przemeck

Abteilung Anästhesiologie I, Medizinische Hochschule Hannover


Carl-Neuberg-Straße 1

30625 Hannover

Email: przemeck.michael@mh-hannover.de