tailieunhanh - Báo cáo y học: " Ultrasound confirmation of guidewire position may eliminate accidental arterial dilatation during central venous cannulation"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Ultrasound confirmation of guidewire position may eliminate accidental arterial dilatation during central venous cannulation | Gillman et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 39 http content 18 1 39 SCANDINAVIAN JOURNAL OF Et emergency medicine ORIGINAL RESEARCH Open Access Ultrasound confirmation of guidewire position may eliminate accidental arterial dilatation during central venous cannulation Lawrence M Gillman 2 3 Michael Blaivas5 Jason Lord4 Azzam Al-Kadi1 3 and Andrew W Kirkpatrick1 2 3 Abstract Background Ultrasound guidance during central line insertion has significantly reduced complications associated with this procedure and has led to it being incorporated as standard of care in many institutions. However inadvertent arterial penetration and dilation remains a problem despite ultrasound guidance and can result in significant morbidity and even mortality. Dynamic ultrasound confirmation of guidewire position within the vein prior to dilation may help to prevent and even eliminate this feared complication. Methods A prospectively collected database of central line insertions for one author utilizing this novel technique was retrospectively reviewed for all incidents of arterial dilation over a period from September 2008 to January 2010. Results During the study period 53 central lines were inserted with no incidents of arterial dilation. Conclusions Ultrasound confirmation of guidewire position has the potential to reduce or eliminate the morbidity and mortality of arterial dilation during central line placement. Background Traditionally central lines were placed blindly using only anatomical landmarks along with proper patient positioning to approximate the location of the appropriate vessel. Adjunct techniques such as utilization of small gauge finder needles may have lowered the incidence of arterial penetration and cannulation but accidental arterial cannulation remained a significant problem. More recently ultrasound has made a move from the radiology department to the bedside and has been integrated into many bedside