Branger B, Zabadani B, Vecina F, Juan J M, Dauzat M
Service de Médecine C et de Néphrologie, Centre Hospitalo-Universitaire de Nîmes.
Nephrologie. 1994;15(2):137-40.
Serious complications may occur after "blind" profound venous puncture in intensive care units. To secure these punctures, we designed a new fingertip pulsed Doppler (FPD) 5 MHz probe with a lateral to center indentation to guide the needle into the ultrasonic flux. A specific ultrasound analyzer indicating depth and diameter of the vessel was made for this use. The material was first tested in an experimental animal study. Results of animal venous punctures were successful 20/21. This material was then tested on patients with previous failure of "blind" punctures: results of 4 FPD punctures were successful in all 12 cases but one (catheterization not completed). We started a prospective multi-unit randomized study with various operators (junior residents, senior staff members), compared the success rate and type, the procedure duration of blind standard versus FPD punctures. We conclude in the safety and easy use of the FPD for central venous punctures.
在重症监护病房进行“盲穿”深静脉穿刺后可能会出现严重并发症。为确保此类穿刺的安全性，我们设计了一种新型的5兆赫指尖脉冲多普勒（FPD）探头，其具有从侧面到中心的凹槽，用于引导穿刺针进入超声束。为此专门制作了一种可指示血管深度和直径的超声分析仪。该材料首先在动物实验研究中进行了测试。动物静脉穿刺的成功率为20/21。然后，对先前“盲穿”失败的患者进行了该材料的测试：在12例患者中，除1例（未完成导管插入术）外，其余4例FPD穿刺均成功。我们启动了一项由不同操作人员（初级住院医师、资深工作人员）参与的前瞻性多单位随机研究，比较了盲法标准穿刺与FPD穿刺的成功率、类型以及操作持续时间。我们得出结论，FPD用于中心静脉穿刺具有安全性且易于使用。
