Application of needle preloaded with guide-wire technology in pediatric ultrasound-guided brachiocephalic vein catheterization
Objective To evaluate the efficacy and safety of needle preloaded with a guide-wire for ultrasound-guided catheterization of brachiocephalic vein(BCV)in pediatric patients.Methods The needle was attached to the plastic cover of the guide-wire prior to skin puncture,and the guide-wire was then advanced near the tip of the needle.The probe was placed in the supraclavicular fossa,and then BCV puncture and guide-wire advancement was strictly under the long axis in-plane ultrasound-guided from lateral to medial of the probe.Success rates of vascular puncture,guide-wire and catheter placement,as well as immediate complications,were assessed.Results A total of 60 infant patients were included in this prospective observational study.The mean±standard deviation(SD)of age and weight was 135 days(range 4～330 days)and 5.8 kg(2.8～8.9 kg),respectively.All puncture attempts were≤3;the success rate on the first attempt was 70%.The guide-wire attempts were also≤3;the successful insertion on the first attempt was 92%.The catheter placement attempts were≤2;the successful placement on the first attempt was 92%and the overall success rate of CVC was 100%.Four patients(7%)had subcutaneous hematoma during venipuncture.There were no significant differ-ences between left and right BCV in the success rates of vascular puncture,guide-wire and catheter placement(P>0.05).Conclusion The needle preloaded with a guide-wire can be used safely and effectively in supra-clavicular ultrasound-guided BCV catheterization in pediatric patients.The choice of left or right BCV may depend on each clinical context and operator experience.
万方数据
维普
