n engl j m

Apuntes

n engl j med 356;21 www.nejm.org may 24, 2007 e21 Central Venous Catheterization Alan S. Graham, M.D., Caroline Ozment, M.D., Ken Tegtmeyer, M.D., Susanna Lai, M.P.H., and Dana A.V. Braner, M.D. From the Department of Pediatrics, Divi- sion of Pediatric Critical Care, Doernbecher Children’s Hospital, Portland, OR (A.S.G., K.T., S.L., D.A.V.B.); and the Department of Pediatrics, Division of Pediatric Critical Care, Duke University, Durham, NC (C.O.). Address reprint requests to Dr. Tegtmeyer at the Department of Pediatrics, Division of Pediatric Critical Care, Doernbecher Children’s Hospital, Oregon Health & Science University, Mail Code: CDRC-P, 707 SW Gaines St., Portland, OR 97239- 2901, or at tegtmeye@ohsu.edu. N Engl J Med 2007;356:e21. Copyright © 2007 Massachusetts Medical Society. Indications Central venous catheterization provides a route for delivery of caustic or critical medications and allows measurement of central venous pressure. Contraindications General contraindications for the placement of a central venous catheter include infection of the area overlying the target vein and thrombosis of the target vein; site-specific and relative contraindications include coagulo...