Stefanidis Konstantinos, Pentilas Nicos, Dimopoulos Stavros, Nanas Serafim, Savel Richard H, Shiloh Ariel L, Poularas John, Slama Michel, Karakitsos Dimitrios
Radiology Department, Evangelismos University Hospital, Athens, Greece.
Crit Care Res Pract. 2012;2012:306182. doi: 10.1155/2012/306182. Epub 2012 May 10.
Objective. Echogenic technology has recently enhanced the ability of cannulas to be visualized during ultrasound-guided vascular access. We studied whether the use of an EC could improve visualization if compared with a nonechogenic vascular cannula (NEC) during real-time ultrasound-guided internal jugular vein (IJV) cannulation in the intensive care unit (ICU). Material and Methods. We prospectively enrolled 80 mechanically ventilated patients who required central venous access in a randomized study that was conducted in two medical-surgical ICUs. Forty patients underwent EC and 40 patients were randomized to NEC. The procedure was ultrasound-guided IJV cannulation via a transverse approach. Results. The EC group exhibited increased visibility as compared to the NEC group (88% ± 8% versus 20% ± 15%, resp. P < 0.01). There was strong agreement between the procedure operators and independent observers (k = 0.9; 95% confidence intervals assessed by bootstrap analysis = 0.87-0.95; P < 0.01). Access time (5.2 s ± 2.5 versus 10.6 s ± 5.7) and mechanical complications were both decreased in the EC group compared to the NEC group (P < 0.05). Conclusion. Echogenic technology significantly improved cannula visibility and decreased access time and mechanical complications during real-time ultrasound-guided IJV cannulation via a transverse approach.
目的。回声技术最近增强了在超声引导下进行血管穿刺时套管的可视化能力。我们研究了在重症监护病房（ICU）进行实时超声引导下颈内静脉（IJV）穿刺时，与无回声血管套管（NEC）相比，使用回声套管（EC）是否能改善可视化效果。材料与方法。我们在两个内科 - 外科ICU进行了一项随机研究，前瞻性纳入了80例需要中心静脉通路的机械通气患者。40例患者接受EC穿刺，40例患者随机接受NEC穿刺。该操作是通过横向入路进行超声引导下的IJV穿刺。结果。与NEC组相比，EC组的可见度增加（分别为88% ± 8%和20% ± 15%，P < 0.01）。操作医生与独立观察者之间有很强的一致性（k = 0.9；通过自抽样分析评估的95%置信区间 = 0.87 - 0.95；P < 0.01）。与NEC组相比，EC组的穿刺时间（5.2 s ± 2.5对10.6 s ± 5.7）和机械并发症均减少（P < 0.05）。结论。回声技术在通过横向入路进行实时超声引导下IJV穿刺时，显著提高了套管的可见度，减少了穿刺时间和机械并发症。
