Salemi S, Sparacia B, Costa R, Cracchiolo A N, Gristina E, Sansone A
Istituto di Anestesia, Rianimazione e dell'Emergenza, Università degli Studi, Palermo.
Minerva Anestesiol. 1998 Dec;64(12):563-6.
The cannulation technique of the subclavian vein by the external jugular vein is described.
To point out this simple and safe method without complications deriving from the direct needle-prick of the subclavian vein.
Experimental plan. The comparative study includes 30 patients in the resuscitation department during the second half-year in 1996. Place. Resuscitation Department of the University Polyclinic in Palermo. Patients. 30% of these patients were male and 70% were female; coagulative serious disorders were present in some patients, in others the coagulative picture was unknown. Interventions and observations. The modified Seldinger technique has ben used, introducing a J wire through the needle cannula put in the external jugular vein, taking care not to exceed the length of the latter with the J wire. Less rigid and small catheters have been used which can fluctuate in the running blood and be carried in the superior vein cava. Once the subclavian vein has been cannulated, a Rx graph control of the thorax was made, showing the excellent position of the catheter.
Only one failure, but this technique has not showed complications.
This technique finds applications in all situations of extreme emergency, in which on the one hand it needs a central blood vessel, on the other there are hemorrhagic problems or there isn't any possibility to do a coagulative screening in short time.
描述了通过颈外静脉进行锁骨下静脉插管的技术。
指出这种简单且安全的方法，避免锁骨下静脉直接针刺带来的并发症。
实验方案。对比研究纳入了1996年下半年复苏科的30例患者。地点：巴勒莫大学综合诊所复苏科。患者：这些患者中30%为男性，70%为女性；部分患者存在严重凝血障碍，其他患者凝血情况不明。干预与观察：采用改良的Seldinger技术，通过置于颈外静脉的针套管引入J形导丝，注意J形导丝不要超出颈外静脉的长度。使用了较柔软且管径较小的导管，其可在流动血液中摆动并进入上腔静脉。一旦完成锁骨下静脉插管，进行胸部X线检查，显示导管位置良好。
仅1例失败，但该技术未出现并发症。
该技术适用于所有极端紧急情况，一方面需要中心血管，另一方面存在出血问题或无法在短时间内进行凝血筛查。
