Brugioni Lucio, Barchetti Marco, Tazzioli Giovanni, Gelmini Roberta, Girardis Massimo, Bianchini Marcello, Schepis Filippo, Nicolini Matteo, Pinelli Giovanni, Martella Pietro, Barozzi Marco, Mori Francesca, Scarabottini Serena, Righetti Andrea, Ravazzini Mirco, Bertellini Elisabetta
Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
J Vasc Access. 2019 May;20(3):325-328. doi: 10.1177/1129729818801302. Epub 2018 Sep 25.
In patients with difficult peripheral venous access, alternative techniques require expertise and are invasive, expensive, and prone to serious adverse events. This brought us to designing a new venous catheter (JLB® Deltamed, Inc.) for the cannulation of medium and large bore veins; it is echogenic, and available in different lengths (60 / 70 / 80 mm) and Gauges (14 / 16 / 17 / 18).
We led a multi-center observational convenience sampling study to evaluate safety and effectiveness of JLB. Data was collected from June 2015 to February 2018. Inclusion criteria were age ⩾ 18, difficulty in obtaining superficial venous access in the veins of the arm, need for rapid infusion, or patient's preference.
We enrolled 1000 patients, mean age 66.8 years. In total, 951 (95.1%) had the device placed in internal jugular vein, 28 in basilic or cephalic vein, 15 in femoral vein, 5 in axillary vein (infra-clavicular tract), and 1 in the external jugular vein. The procedure was performed by attending physicians or emergency medicine residents under US guidance. Mean procedure time (from disinfection to securing) was approximately 240 s. Mean attempts number was 1.21. Early complications (<24 h) occurred in four patients, consisting in two soft tissue hematoma, one phlebitis, and one atrial tachyarrhythmia. No major complications (such as pneumothorax) were reported. Mean indwelling time was 168 h (7 days); early occlusion/dislocation occurred in four cases.
According to preliminary data, the application of JLB appears to be safe, cost-effective, and rapid to place bedside.
对于外周静脉穿刺困难的患者，替代技术需要专业技能，且具有侵入性、费用高昂并容易引发严重不良事件。这促使我们设计一种新的静脉导管（JLB®，德尔塔医疗公司）用于中大型静脉的插管；它具有回声，有不同长度（60/70/80毫米）和规格（14/16/17/18）可供选择。
我们开展了一项多中心观察性便利抽样研究，以评估JLB的安全性和有效性。数据收集时间为2015年6月至2018年2月。纳入标准为年龄≥18岁、手臂静脉浅表静脉穿刺困难、需要快速输液或患者偏好。
我们纳入了1000例患者，平均年龄66.8岁。总共有951例（95.1%）将该装置置于颈内静脉，28例置于贵要静脉或头静脉，15例置于股静脉，5例置于腋静脉（锁骨下途径），1例置于颈外静脉。该操作由主治医生或急诊医学住院医师在美国超声引导下进行。平均操作时间（从消毒到固定）约为240秒。平均尝试次数为1.21次。4例患者出现早期并发症（<24小时），包括2例软组织血肿、1例静脉炎和1例房性快速心律失常。未报告重大并发症（如气胸）。平均留置时间为168小时（7天）；4例发生早期堵塞/移位。
根据初步数据，JLB的应用似乎是安全、经济高效且在床边放置迅速的。
