Chetioui Adrien, Masia Thibaud, Claret Pierre-Géraud, Markarian Thibaut, Muller Laurent, Lefrant Jean Yves, de La Coussaye Jean Emmanuel, Roger Claire, Bobbia Xavier
1 Department of Anesthesiology, Emergency and Critical Care Medicine, Intensive Care Unit, Nîmes University Hospital, Nîmes, France.
2 Emergency Department, Timone 2 Hospital, Aix-Marseille University, Marseille, France.
J Vasc Access. 2019 Jul;20(4):404-408. doi: 10.1177/1129729818812733. Epub 2018 Nov 20.
The aims of our study were to compare the performance of experienced emergency physicians for internal jugular vein puncture using a conventional ultrasound device versus a pocket-sized ultrasound in a training model.
In this single-center, prospective, randomized study, emergency physicians performed one puncture with each device in a randomized order. No emergency physicians used a pocket-sized ultrasound for central vascular catheter insertion in clinical practice. A medium-fidelity training model was used. Each image was judged based on an image quality scale from 0 to 5.
Twenty emergency physicians were included: nine females (45%), median experience 2.5 years [2.0;4.3]. The median time to achieve a puncture with the conventional ultrasound device was 22 s [17;26] versus 28 s [13;43] with the pocket-sized ultrasound ( = 0.43). Eighteen (90%) emergency physician punctures were successful with the conventional ultrasound device versus 18 (90%) with the pocket-sized ultrasound ( = 1). The image quality was 4 [3;5] in the conventional ultrasound device group versus 4 [3;5] in the pocket-sized ultrasound group ( = 0.32).
Pocket-sized ultrasound and conventional ultrasound device performances are not statistically different for internal jugular vein-guided ultrasonography in a training model. These results must be confirmed in a clinical study.
我们研究的目的是在训练模型中比较经验丰富的急诊医师使用传统超声设备与袖珍超声进行颈内静脉穿刺的操作表现。
在这项单中心、前瞻性、随机研究中,急诊医师按随机顺序使用每种设备进行一次穿刺。没有急诊医师在临床实践中使用袖珍超声进行中心血管导管插入。使用了中等逼真度的训练模型。每张图像根据0至5的图像质量量表进行评判。
纳入了20名急诊医师:9名女性(45%),中位经验2.5年[2.0;4.3]。使用传统超声设备完成穿刺的中位时间为22秒[17;26],而使用袖珍超声为28秒[13;43](=0.43)。使用传统超声设备18例(90%)急诊医师穿刺成功,使用袖珍超声18例(90%)穿刺成功(=1)。传统超声设备组的图像质量为4[3;5],袖珍超声组为4[3;5](=0.32)。
在训练模型中,对于颈内静脉引导超声检查,袖珍超声和传统超声设备的操作表现无统计学差异。这些结果必须在临床研究中得到证实。