Background:Peripherally Inserted Central Catheters play an increasingly important role in Central Venous Access Devices. However, the use of these devices should be carefully considered in specific situations such as central catheterisation in patients with chronic kidney disease. When evaluating the feasibility of placement for a patient undergoing dialysis, the relationship between changes in circulating volume before and after dialysis treatment, and potential variations in the size of deep veins in the upper limbs, should be considered.Materials:Upper limb veins, specifically the basilic or brachial veins, were identified and measured before and after dialysis treatment. Patient data and weight loss data during dialysis treatment were also collected. Linear regression analysis was performed to assess the correlation between the variables.Results:The average variation in vein size for the entire sample was +0.17 ± 0.43 mm. The mean volume removed was 2.2 ± 0.8 l. In subgroup 1 (fluid volume loss <2000 ml), the population experienced a decrease in the measured vein size after dialysis. In subgroup 2 (fluid volume loss ⩾2000 ml), the population experienced an increase in the measured vein size after dialysis.Conclusions:Upper arm vascular access placement in dialysed patients with fluid removal of less than 2000 ml should be performed after the dialysis session. Conversely, in dialysed patients with fluid removal of more than 2000 ml, where a significant increase in vein size was observed, vascular access placement should be performed before the dialysis session when the veins are smaller. Additionally, it should be noted that in patients with chronic kidney disease, the venous system of the upper limbs should be preserved as much as possible to prevent thrombosis and stenosis in potential arteriovenous fistula creation.

中文翻译：

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透析治疗期间 PICC 插入和手臂大小变化的静脉：一项前瞻性观察研究

背景：外周插入中心静脉导管在中心静脉接入装置中发挥着越来越重要的作用。然而，在特定情况下应仔细考虑这些设备的使用，例如慢性肾病患者的中心导管插入术。在评估接受透析的患者放置的可行性时，应考虑透析治疗前后循环容量的变化与上肢深静脉尺寸的潜在变化之间的关系。 材料：上肢静脉，特别是在透析治疗之前和之后识别和测量贵要静脉或肱静脉。还收集了透析治疗期间的患者数据和体重减轻数据。进行线性回归分析以评估变量之间的相关性。结果：整个样本的静脉尺寸的平均变化为+0.17±0.43毫米。去除的平均体积为 2.2 ± 0.8 l。在亚组 1 中（液体体积损失 <2000 毫升），透析后人群的测量静脉尺寸有所减小。在亚组 2 中（液体量损失⩾2000 ml），人群在透析后测得的静脉直径有所增加。结论：对于液体排出量少于 2000 ml 的透析患者，应在透析结束后进行上臂血管通路放置。相反，对于液体排出量超过 2000 ml 的透析患者，观察到静脉尺寸显着增加，当静脉较小时，应在透析之前进行血管通路放置。另外，需要注意的是，慢性肾脏病患者应尽可能保留上肢静脉系统，防止潜在动静脉瘘形成时发生血栓和狭窄。