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Can you justify not using ultrasound guidance for central venous access?你能说明不使用超声引导进行中心静脉置管的理由吗？
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本文引用的文献

1
Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients.实时超声引导下颈内静脉置管：与危重症患者标志性技术的前瞻性比较
Crit Care. 2006;10(6):R162. doi: 10.1186/cc5101.
2
Editorial II: Ultrasound imaging by anaesthetists: training and accreditation issues.
Br J Anaesth. 2006 Apr;96(4):414-7. doi: 10.1093/bja/ael032.
3
Ultrasound-guided arterial cannulation in infants improves success rate.超声引导下婴儿动脉置管可提高成功率。
Eur J Anaesthesiol. 2006 Jun;23(6):476-80. doi: 10.1017/S0265021506000275. Epub 2006 Mar 2.
4
Visualisation of needle position using ultrasonography.使用超声检查可视化针的位置。
Anaesthesia. 2006 Feb;61(2):148-58. doi: 10.1111/j.1365-2044.2005.04475.x.
5
A randomized trial assessing the value of ultrasound-guided puncture of the femoral artery for interventional investigations.
Int J Cardiovasc Imaging. 2004 Oct;20(5):363-8. doi: 10.1023/b:caim.0000041949.59255.3f.
6
Ultrasound-guided infraclavicular axillary vein cannulation for central venous access.超声引导下锁骨下腋静脉置管用于中心静脉通路
Br J Anaesth. 2004 Aug;93(2):188-92. doi: 10.1093/bja/aeh187. Epub 2004 Jun 25.
7
Mid-arm approach to basilic and cephalic vein cannulation using ultrasound guidance.超声引导下经上臂途径行贵要静脉和头静脉置管
Br J Anaesth. 2004 Aug;93(2):292-4. doi: 10.1093/bja/aeh179. Epub 2004 Jun 11.
8
Ultrasonic locating devices for central venous cannulation: meta-analysis.用于中心静脉置管的超声定位设备：荟萃分析
BMJ. 2003 Aug 16;327(7411):361. doi: 10.1136/bmj.327.7411.361.
9
The effectiveness and cost-effectiveness of ultrasound locating devices for central venous access: a systematic review and economic evaluation.用于中心静脉置管的超声定位设备的有效性和成本效益：一项系统评价和经济评估
Health Technol Assess. 2003;7(12):1-84. doi: 10.3310/hta7120.
10
It's NICE to see in the dark.
Br J Anaesth. 2003 Mar;90(3):269-72. doi: 10.1093/bja/aeg052.

你能说明不使用超声引导进行中心静脉置管的理由吗？

Can you justify not using ultrasound guidance for central venous access?

作者信息

Bodenham Andrew R

机构信息

Department of Anaesthesia, Leeds General Infirmary, Leeds, LS1 3EX, UK.

出版信息

Crit Care. 2006;10(6):175. doi: 10.1186/cc5079.

DOI:10.1186/cc5079
PMID:17129362
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1794450/
Abstract

Karakitsos and coworkers, in this journal, reported further compelling evidence on the value of ultrasound in guiding internal jugular vein catheterization. In a large, prospective, randomized study of 900 patients, comparisons were made between patients in whom the procedure was performed using landmark-based techniques and those assigned to ultrasound guidance. The key benefits from use of ultrasound included reduction in needle puncture time, increased overall success rate (100% versus 94%), reduction in carotid puncture (1% versus 11%), reduction in carotid haematoma (0.4% versus 8.4%), reduction in haemothorax (0% versus 1.7%), decreased pneumothorax (0% versus 2.4%) and reduction in catheter-related infection (10% versus 16%). The implications of these findings are discussed, and a compelling case for routine use of ultrasound to guide central venous access is made.

摘要

卡拉基索斯及其同事在本期刊上报告了关于超声引导颈内静脉置管价值的更多有力证据。在一项针对900例患者的大型前瞻性随机研究中，对采用基于体表标志技术进行该操作的患者与分配至超声引导组的患者进行了比较。使用超声的主要益处包括缩短穿刺时间、提高总体成功率（100%对94%）、减少颈动脉穿刺（1%对11%）、减少颈动脉血肿（0.4%对8.4%）、减少血胸（0%对1.7%）、降低气胸发生率（0%对2.4%）以及减少导管相关感染（10%对16%）。文中讨论了这些研究结果的意义，并提出了常规使用超声引导中心静脉通路的有力理由。