Jones Nadine, Handel Ian G, Llewellyn Efa
Hospital for Small Animals, The Royal (Dick) Veterinary School, The University of Edinburgh, Edinburgh, UK.
The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK.
J Vet Emerg Crit Care (San Antonio). 2022 May;32(3):356-364. doi: 10.1111/vec.13183. Epub 2022 Feb 2.
To compare the success rates and time taken to cannulate the jugular, cephalic, and lateral saphenous veins using a cutdown technique by personnel with 4 different levels of experience.
Prospective ex vivo study.
Veterinary university teaching hospital.
Eighteen canine cadavers.
Recently euthanized canine patients that were donated to the hospital for research purposes between October 2019 and March 2020 were enrolled. Four groups of personnel participated in the study to give 4 varying levels of experience: 8 final year veterinary students, 2 registered veterinary nurses, 1 emergency and critical care intern and 1 ACVECC diplomate. Each cannula placer had 5 minutes to attempt cannulation by venous cutdown at each site. Time to venous cannulation (VC) was compared for each site and group and complications encountered during each attempt recorded.
The overall success rate for cannulation of the jugular, cephalic, and lateral saphenous veins were 81%, 84%, and 87%, respectively. The median times for venous cutdown for all personnel were as follows: jugular vein 119 s (range 51-280 s), cephalic vein 82 s (range 39-291 s), and lateral saphenous vein 110 s (range 41-294 s). There was no difference in time to VC between veins. When comparing personnel at the 3 cannulation sites, the ACVECC diplomate was faster than the registered veterinary nurses and students (P = 0.042 and P = 0.048, respectively). No differences were found between any other groups. Complications encountered often related to cadaver factors such as hematoma from antemortem venipuncture.
All groups were able to perform venous cutdown at each site with good overall success even without prior experience of the technique. VC by cutdown technique of the jugular, cephalic, or lateral saphenous veins may be considered in an emergency setting by personnel of various skill levels.
比较具有4种不同经验水平的人员使用切开技术对颈静脉、头静脉和隐外侧静脉进行插管的成功率和所需时间。
前瞻性离体研究。
兽医大学教学医院。
18具犬类尸体。
纳入2019年10月至2020年3月间捐赠给医院用于研究目的的近期安乐死犬类患者。四组人员参与研究以提供4种不同的经验水平：8名兽医专业最后一年的学生、2名注册兽医护士、1名急诊与重症监护实习生和1名美国兽医急诊与重症护理学会专科医师。每个插管者有5分钟时间尝试在每个部位通过静脉切开进行插管。比较每个部位和组别的静脉插管时间（VC），并记录每次尝试过程中遇到的并发症。
颈静脉、头静脉和隐外侧静脉插管的总体成功率分别为81%、84%和87%。所有人员静脉切开的中位时间如下：颈静脉119秒（范围51 - 280秒），头静脉82秒（范围39 - 291秒），隐外侧静脉110秒（范围41 - 294秒）。各静脉之间的VC时间无差异。在比较3个插管部位的人员时，美国兽医急诊与重症护理学会专科医师比注册兽医护士和学生更快（分别为P = 0.042和P = 0.048）。其他任何组之间均未发现差异。遇到的并发症通常与尸体因素有关，如生前静脉穿刺引起的血肿。
即使没有该技术的先前经验，所有组在每个部位进行静脉切开时总体成功率都较高。各种技能水平的人员在紧急情况下可考虑通过切开技术对颈静脉、头静脉或隐外侧静脉进行VC。
