Vucevic M, Tehan B, Gamlin F, Berridge J C, Boylan M
Academic Unit of Anaesthesia, General Infirmary at Leeds.
Anaesthesia. 1994 Oct;49(10):889-91. doi: 10.1111/j.1365-2044.1994.tb04268.x.
Central venous access is an essential part of patient management in many clinical settings. Traditionally this has been achieved by a blind, external landmark guided technique which may not correlate exactly with the location of the vessel. We have prospectively evaluated the SMART needle, a new Doppler ultrasound guided vascular access device, in 40 patients, to evaluate whether it can improve on the standard technique. The SMART needle was easy to use and reliably distinguished between arterial and venous signals. No advantage was demonstrated in 'easy' internal jugular vein cannulations. Although ease of cannulation in difficult cases was subjectively improved, the differences in time to cannulation and number of passes between the groups failed to reach statistical significance and the complication rates were similar. However, the use of the SMART needle on two occasions enabled avoidance of carotid artery puncture by correctly distinguishing the artery from the vein, so that it may have a rôle in patients in whom difficult internal jugular venous cannulation is anticipated.
在许多临床环境中，中心静脉通路是患者管理的重要组成部分。传统上，这是通过一种盲目、外部标志引导的技术来实现的，该技术可能与血管的位置并不完全相关。我们前瞻性地评估了一种新型多普勒超声引导血管穿刺装置SMART针在40例患者中的应用，以评估其是否能优于标准技术。SMART针易于使用，能可靠地区分动脉和静脉信号。在“容易”的颈内静脉置管中未显示出优势。尽管主观上改善了困难病例的置管难度，但两组之间的置管时间和穿刺次数差异未达到统计学意义，并发症发生率相似。然而，两次使用SMART针通过正确区分动脉和静脉避免了颈动脉穿刺，因此它可能在预计颈内静脉置管困难的患者中发挥作用。
