Chamberlin Scott C, Sullivan Lauren A, Morley Paul S, Boscan Pedro
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.
J Vet Emerg Crit Care (San Antonio). 2013 Sep-Oct;23(5):498-503. doi: 10.1111/vec.12102. Epub 2013 Sep 19.
To describe the technique and determine the feasibility, success rate, perceived difficulty, and time to vascular access using ultrasound guidance for jugular vein catheterization in a cardiac arrest dog model.
Prospective descriptive study.
University teaching hospital.
Nine Walker hounds.
A total of 27 jugular catheterizations were performed postcardiac arrest using ultrasound guidance. Catheterizations were recorded based on the order in which they were performed and presence/absence of a hematoma around the vein. Time (minutes) until successful vascular access and perceived difficulty in achieving vascular access (scale of 1 = easy to 10 = difficult) were recorded for each catheterization. Mean time to vascular access was 1.9 minutes (95% confidence interval, 1.1-3.4 min) for catheterizations without hematoma, versus 4.3 minutes (1.8-10.1 min) for catheterizations with hematoma (P = 0.1). Median perceived difficulty was 2 of 10 (range 1-7) for catheterizations without hematoma, versus 2 of 10 (range 1-8) for catheterizations with hematoma (P = 0.3). A learning curve was evaluated by comparing mean time to vascular access and perceived difficulty in initial versus subsequent catheterizations. Mean time to vascular access was 2.5 minutes (1.0-6.4 min) in the initial 13 catheterizations versus 3.3 minutes (1.5-7.5 min) in the subsequent 14 catheterizations (P = 0.6). Median perceived difficulty in the first 13 catheterizations (3, range 1-8) was significantly greater (P = 0.049) than median perceived difficulty in the subsequent 14 catheterizations (2, range 1-6).
Ultrasound-guided jugular catheterization is associated with a learning curve but is successful in obtaining rapid vascular access in dogs. Further prospective studies are warranted to confirm the utility of this technique in a clinical setting.
描述在心脏骤停犬模型中使用超声引导进行颈静脉置管的技术，并确定其可行性、成功率、感知难度以及获得血管通路的时间。
前瞻性描述性研究。
大学教学医院。
9只沃克猎犬。
心脏骤停后使用超声引导共进行了27次颈静脉置管。根据置管顺序以及静脉周围有无血肿记录置管情况。记录每次置管成功获得血管通路的时间（分钟）以及获得血管通路的感知难度（范围为1 = 容易至10 = 困难）。无血肿的置管平均获得血管通路时间为1.9分钟（95%置信区间，1.1 - 3.4分钟），有血肿的置管为4.3分钟（1.8 - 10.1分钟）（P = 0.1）。无血肿置管的感知难度中位数为10分中的2分（范围1 - 7），有血肿置管为10分中的2分（范围1 - 8）（P = 0.3）。通过比较初次与后续置管获得血管通路的平均时间和感知难度来评估学习曲线。最初13次置管的平均获得血管通路时间为2.5分钟（1.0 - 6.4分钟），后续14次置管为3.3分钟（1.5 - 7.5分钟）（P = 0.6）。最初13次置管的感知难度中位数（3，范围1 - 8）显著高于后续14次置管的感知难度中位数（2，范围1 - 6）（P = 0.049）。
超声引导下颈静脉置管存在学习曲线，但在犬中能成功快速获得血管通路。有必要进行进一步的前瞻性研究以证实该技术在临床环境中的实用性。
