Cole Ian, Glass Casey, Norton H James, Tayal Vivek
Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina, USA.
J Emerg Med. 2012 Jul;43(1):87-92. doi: 10.1016/j.jemermed.2011.06.034. Epub 2011 Oct 5.
Saphenous vein cutdown is a rare venous access procedure. Ultrasound (US) can assist with many vascular access procedures.
Our objective was to identify the saphenous veins (SVs) using US in pediatric emergency department (ED) patients, and to determine if the SV size allows for potential cannulation by different standard-size intravenous (i.v.) catheters.
This study was a prospective, observational convenience sample of 60 pediatric patients at an urban, regional referral pediatric ED. Inclusion criteria were children ages 1 through 12 years categorized into four age groups: 1-<2, 2-4, 5-7, and 8-12 years, with informed consent and assent. Investigators performed US examination using a 10-MHz multi-frequency transducer to identify the SV on both legs and measure the SV in short-axis view. The US measurements were then used to calculate the SV areas. Diameters of typical pediatric gauge (G) catheters (24G, 22G, 20G, 18G) were used to calculate catheter areas.
Sixty patients were enrolled, with five SVs unable to be measured in 4 patients (1 patient with both SVs). For the remaining 115 (96%) SVs available for further analysis, the median age was 4 years (interquartile range [IQR] 2) and median weight was 22.7 kg (IQR 14.5). Mean area (mm(2)) of the right SV was 2.85 ± 1.9 and for the left SV, 2.88 ± 1.8. For our study group, the compatibility rates of different size i.v. catheters to fit the measured SV areas were as follows: 24G = 100%, 22G = 100%, 20G = 97.3%, and 18G =86.1%.
US can localize the SV in pediatric ED patients. US size of the SV in various pediatric age ranges suggests that the SV may be a potential US venous access site with multiple-size i.v. catheters up to 18G.
大隐静脉切开术是一种罕见的静脉穿刺置管操作。超声（US）可辅助多种血管穿刺置管操作。
我们的目的是在儿科急诊科（ED）患者中使用超声识别大隐静脉（SVs），并确定SV的大小是否允许使用不同标准尺寸的静脉内（i.v.）导管进行潜在的置管。
本研究是一项对一家城市地区转诊儿科急诊科的60例儿科患者进行的前瞻性观察性便利样本研究。纳入标准为年龄1至12岁的儿童，分为四个年龄组：1 - <2岁、2 - 4岁、5 - 7岁和8 - 12岁，均获得知情同意和同意。研究人员使用10兆赫多频探头进行超声检查，以识别双腿的SV，并在短轴视图中测量SV。然后使用超声测量值计算SV面积。使用典型儿科规格（G）导管（24G、22G、20G、18G）的直径计算导管面积。
共纳入60例患者，4例患者（1例患者的双侧SV）中有5条SV无法测量。对于其余115条（96%）可用于进一步分析的SV，中位年龄为4岁（四分位间距[IQR]为2），中位体重为22.7千克（IQR为14.5）。右侧SV的平均面积（mm²）为2.85±1.9，左侧SV为2.88±1.8。对于我们的研究组，不同尺寸i.v.导管与测量的SV面积的适配率如下：24G = 100%，22G = 100%，20G = 97.3%，18G = 86.1%。
超声可在儿科ED患者中定位SV。不同儿科年龄范围内SV的超声测量大小表明，SV可能是一个潜在的超声引导静脉穿刺置管部位，可使用高达18G的多种尺寸i.v.导管。
