Fundación Valle del Lili, Departamento de Emergencias, Cali, Colombia.
Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia.
J Vasc Access. 2021 Mar;22(2):288-291. doi: 10.1177/1129729820938191. Epub 2020 Jul 7.
Radiological studies that require contrast media are common and useful in the emergency department. Alternatives have been proposed for the administration of contrast agent in patients with difficulty in the insertion of vascular access. Since 2017, our institution has used a 4-Fr × 10-cm-long peripheral catheter (Leadercath; Vygon) for venous insertion. Its ultrasound-guided insertion is carried out by emergency physicians. So far, there are no reports in the literature about the use of this long peripheral catheter for computed tomography angiography.
To describe the experience with the said device, to point out the complications associated with it, and to evaluate it as an alternative way to gain vascular access for patients with limited venous access.
An observational, analytical, and retrospective study was conducted. The study included patients who received an ultrasound-guided 4-Fr × 10-cm-long peripheral catheter (Leadercath; Vygon). Transparent, radiopaque, polyethylene, 18-gauge Leadercath from Vygon, sold as peripheral arterial catheter and sometimes used "off-label" as venous catheter with a flow capacity of up to 24 mL/min, was used. The flow capacity for gravity flow is 24 mL/s; with pump-driven flow, we achieved a flow infusion of 5-6 mL/s. Univariate analyses were performed. Normality was determined through the Shapiro-Wilk test.
In total, 172 patients met the inclusion criteria. Of them, 115 (67%) were female and the average age was 59 years. The main indication for performing the computed tomography angiography was the suspicion of pulmonary embolism (38.6%). The most frequent type of computed tomography angiography study was pulmonary tomography (88 patients, 51.5%). The contrast medium infusion rate was 6 mL/s in 51.5% (n = 88) of cases, 4.5 mL/s in 36.3%, and 5 mL/s in 12.3%. One adverse event occurred.
An 18-gauge-long peripheral catheter (4 Fr × 10 cm, Leadercath; Vygon) following specific protocols appears to be safe for conducting high-flow computed tomography studies in patients with limited venous access.
需要对比剂的放射学研究在急诊科中很常见且非常有用。对于血管通路插入困难的患者，已经提出了替代对比剂给药的方法。自 2017 年以来，我们机构一直使用一种 4Fr×10cm 长的外周导管（Leadercath；Vygon）进行静脉插入。其超声引导插入由急诊医师进行。到目前为止，文献中尚无关于将这种长外周导管用于计算机断层血管造影术的报道。
描述使用该设备的经验，指出与之相关的并发症，并评估其作为获得静脉通路有限的患者血管通路的替代方法。
进行了一项观察性、分析性和回顾性研究。该研究纳入了接受超声引导的 4Fr×10cm 长外周导管（Leadercath；Vygon）的患者。使用的是 Vygon 生产的透明、不透射线、聚乙烯、18 号 Leadercath，作为外周动脉导管销售，有时“超适应证”用作静脉导管，流量可达 24mL/min，重力流的流量为 24mL/s；使用泵驱动时，我们实现了 5-6mL/s 的流速输注。进行了单变量分析。通过 Shapiro-Wilk 检验确定正态性。
共有 172 名患者符合纳入标准。其中，115 名（67%）为女性，平均年龄为 59 岁。进行计算机断层血管造影的主要指征是怀疑肺栓塞（38.6%）。最常见的计算机断层血管造影研究类型是肺断层扫描（88 名患者，51.5%）。6mL/s 的造影剂输注率在 51.5%（n=88）的病例中，4.5mL/s 的占 36.3%，5mL/s 的占 12.3%。发生了 1 起不良事件。
按照特定方案使用 18 号长外周导管（4Fr×10cm，Leadercath；Vygon）似乎可安全用于静脉通路有限的患者进行高流量计算机断层扫描研究。
