Name: the supraclavicular fossa ultrasound view for central venous catheter placement and catheter change over guidewire
Uploaded: 2014-12-23T14:00:00.000+00:00
Duration: 7 min 47 s
Description: Watch this Scientific Journal Video about The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire at JoVE.com

注意:以下协议遵循我们的内部指引及批准本部门的椅子标准操作程序。相同的方案经我们的机构审查委员会和用于发表在以前的论文8的研究。 1.预超声波扫描准备<ol><li>放置在患者中使用可选的提高压头的床仰卧位置或担架舒适如果病人是醒着。 </li><li>定位超声波机与operator&#39;s位置和穿刺部位，以防止operator&#39;s头部或身体扭动看到显示一条线。打开超声波机并连接微型凸超声探头。 </li><li>选择一个预先设定的允许深部组织穿透， 例如，设置探测到8 MHz或更低。使用在皮肤上酒精消毒超声探头的声耦合。 </li></ol>在我CVC 2.超声波扫描nsertion站点和上腔静脉<ol><li>放置在微凸超声波探头上的穿刺部位。 注意:B（正当性）-mode短轴视图和平面外穿刺技术是优选的。调整增益，深度和焦点位置，以便获得最佳的图像。 </li><li>通过施加压力来测试压缩性和排除血栓在穿刺部位确认静脉。使用彩色血流多普勒，如果有不确定性。将超声探头集中检测到潜在的血栓。 </li></ol> 3.锁骨上窝超声查看<ol><li>放置超声探头在右锁骨上窝，得到颈内静脉和锁骨下静脉的汇合，以检测潜在的血栓的图。改变增益，深度和集中使用超声波机的旋钮。 注意:设置增益足够高回声血管壁和低回声血管腔之间的区别。集深度（10-12厘米），以具有SVC和r的完整视图飞行肺动脉（RPA）。将焦点设置到RPA的水平。 </li><li>使用超声波机的旋钮来获得头臂静脉汇合处的视图增加深度（4-6厘米）。这也将对应的上腔静脉的开始。调整深度的超声探头（10-12厘米），成角，以获得上腔静脉，相邻的升主动脉和右肺动脉的完整纵向视图。 注:探头频率将由超声波机根据成像深度调整。 </li><li>评价头臂静脉和上腔静脉进行静脉血栓。打开超声波探头90°顺时针，得到上腔静脉的矢状图。观察右肺动脉中的下腔静脉的短轴背侧。此外，观察肺静脉远端右肺动脉的短轴图。使用可选的多普勒确认上腔CAV一。 </li></ol> 4.超声引导下静脉穿刺<ol><li> CVC准备工具包和礼服用无菌袍和手套。皮肤消毒用酒精湿巾和应用无菌单。将超声探头进入无菌盖。超声引导静脉穿刺所用的非镇静，以及在麻醉患者中进行。 注:对于非镇静患者静脉穿刺前局部浸润麻醉，强烈推荐。 </li><li>获得静脉的超声波视图被穿刺。右利手操作者使用连接于在右手注射器和在左手超声波探头的针头。 </li><li>执行超声引导下静脉穿刺。 注:出平面和平面技术都是合适的。 </li><li>以下静脉穿刺，通过针插入导丝。在这一点上，静脉的长轴视图可以确认在静脉内的导引线。 </li></ol> 5.超声引导Guidewi再进步<ol><li>切换超​​声探头右手。通过调节深度获得的上腔静脉的看法和聚焦超声图像（ 图3A和补充视频环）的位置。 注意:这必须是一个协助人或由运营商自己做，如果超声机器用无菌盖操作。超声波探头的角度需要在相对于颈部的小角度。 </li><li>前进用左手的导线。不引入导线太远进入上腔静脉，因为这将使得难以识别导丝尖。前进右肺动脉（ 图3B）的上壁部及交叉时可视化的导线的J-小费。 </li><li>如果超声波束不能与J尖端和右肺动脉对齐，使用升主动脉为地标。打开超声波探头90°顺时针获得的矢状图上腔静脉。以这种观点，确认导丝位置相对于右肺动脉中的短轴观察到的。 </li></ol> 6.测量插入深度<ol><li>使用中央静脉导管以测量导线的插入深度。为了做到这一点，校准20厘米标记的CVC和导丝并读取厘米在静脉穿刺部位的标记。 注:导线具有标记，10％，20厘米，在位置指示的J-尖叶远侧内腔。这些标记可能会根据不同的制造商。要小心，不要动导丝。 注:按照标准的医院协议，包括皮肤和静脉，插入CVC超过导丝，愿望和冲洗和缝合扩张这个角度上，完整的布局。 </li></ol> 7.肺超声<ol><li>在围手术期，在患者进行肺超声检查排除气胸以下CVC位置。 注:此过程已经由利希滕斯坦等11。 </li><li>将超声波探头中的所有四个象限前胸部的两侧，以获得图中B模式为肺滑动和M模式为海滨标志。最好使用线性超声探头。对于肥胖患者，用超声波探头具有较高的渗透， 如弧形阵列或微凸探头。 </li></ol> 8.中心静脉导管改过来导丝注:在导线CVC变化是单个贡献者导管相关血流感染，应该避免。患者的机械并发症有关的CVC插入或有限静脉通路的高风险，过导线CVC变化仍可以被认为是12。 <ol><li>如果放错了地方的中心静脉导管（未使用超声引导下的尖端位置法），获得超锁骨视图推进导引线到正确的位置。在无菌条件下，引入一个导线插入错位中心静脉导管的远端内腔。变化的CVC超过超声引导导丝工作在非镇静的病人，以及在麻醉的患者。 <ol><li>拉回中心静脉导管。可视化从thesupraclavicular窝观点导丝。 </li><li>推进导丝插入在上腔静脉的正确位置。引入新的中心静脉导管在导丝。 </li><li>按照标准的医院协议这一点上，整个程序。 </li></ol></li></ol>

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	<li>Troianos, C. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Special+articles:+guidelines+for+performing+ultrasound+guided+vascular+cannulation:+recommendations+of+the+American+Society+of+Echocardiography+and+the+Society+Of+Cardiovascular+Anesthesiologists.">Special articles: guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society Of Cardiovascular Anesthesiologists.</a> Anesth Analg. 114 (1), 46-72 (2012).</li><li>Cavanna, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound-guided+central+venous+catheterization+in+cancer+patients+improves+the+success+rate+of+cannulation+and+reduces+mechanical+complications:+a+prospective+observational+study+of+1,978+consecutive+catheterizations.">Ultrasound-guided central venous catheterization in cancer patients improves the success rate of cannulation and reduces mechanical complications: a prospective observational study of 1,978 consecutive catheterizations.</a> World J Surg Oncol. 8 (91), (2010).</li><li>Wirsing, M., Schummer, C., Neumann, R., Steenbeck, J., Schmidt, P., Schummer, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Is+traditional+reading+of+the+bedside+chest+radiograph+appropriate+to+detect+intraatrial+central+venous+catheter+position.">Is traditional reading of the bedside chest radiograph appropriate to detect intraatrial central venous catheter position.</a> Chest. 134 (3), 527-533 (2008).</li><li>Ender, J., Erdoes, G., Krohmer, E., Olthoff, D., Mukherjee, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transesophageal+echocardiography+for+verification+of+the+position+of+the+electrocardiographically-placed+central+venous+catheter.">Transesophageal echocardiography for verification of the position of the electrocardiographically-placed central venous catheter.</a> J Cardiothorac Vasc Anesth. 23 (4), 457-461 (2009).</li><li>Pittiruti, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+intracavitary+ECG+method+for+positioning+the+tip+of+central+venous+catheters:+results+of+an+Italian+multicenter+study.">The intracavitary ECG method for positioning the tip of central venous catheters: results of an Italian multicenter study.</a> J Vasc Access. 13 (3), 357-365 (2012).</li><li>Matsushima, K., Frankel, H. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bedside+ultrasound+can+safely+eliminate+the+need+for+chest+radiographs+after+central+venous+catheter+placement:+CVC+sono+in+the+surgical+ICU+(SICU).">Bedside ultrasound can safely eliminate the need for chest radiographs after central venous catheter placement: CVC sono in the surgical ICU (SICU).</a> J Surg Res. 163 (1), 155-161 (2010).</li><li>Matsushima, K., Frankel, H. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detection+of+central+venous+catheter+insertion-related+complication+using+bedside+ultrasound:+the+CVC+sono.">Detection of central venous catheter insertion-related complication using bedside ultrasound: the CVC sono.</a> J Trauma. 70 (6), 1561-1563 (2011).</li><li>Kim, S. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+confirmation+of+central+venous+catheter+position+via+a+right+supraclavicular+fossa+view+using+a+microconvex+probe:+A+observational+pilot+study.">Ultrasound confirmation of central venous catheter position via a right supraclavicular fossa view using a microconvex probe: A observational pilot study.</a> Eur J Anaesthesiol. , (2013).</li><li>Lanspa, M. J., Fair, J., Hirshberg, E. L., Grissom, C. K., Brown, S. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound-guided+Subclavian+Vein+Cannulation+Using+a+Micro-Convex+Ultrasound+Probe.">Ultrasound-guided Subclavian Vein Cannulation Using a Micro-Convex Ultrasound Probe.</a> Ann Am Thorac Soc. 11 (4), 583-586 (2014).</li><li>Weber, S. U., Kim, S. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+right+supraclavicular+ultrasound+view+for+real-time+ultrasound-guided+definite+placement+of+a+central+venous+catheter+with+a+microconvex+transducer.">The right supraclavicular ultrasound view for real-time ultrasound-guided definite placement of a central venous catheter with a microconvex transducer.</a> Eur J Anaesthesiol. 31 (3), 173-174 (2014).</li><li>Lichtenstein, D. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+diagnosis+of+occult+pneumothorax.">Ultrasound diagnosis of occult pneumothorax.</a> Crit Care Med. 33 (6), 1231-1238 (2005).</li><li>Garnacho-Montero, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+factors+and+prognosis+of+catheter-related+bloodstream+infection+in+critically+ill+patients:+a+multicenter+study.">Risk factors and prognosis of catheter-related bloodstream infection in critically ill patients: a multicenter study.</a> Intensive Care Med. 34 (12), 2185-2193 (2008).</li><li>Schummer, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intra-atrial+ECG+is+not+a+reliable+method+for+positioning+left+internal+jugular+vein+catheters.">Intra-atrial ECG is not a reliable method for positioning left internal jugular vein catheters.</a> Br J Anaesth. 91 (4), 481-486 (2003).</li></ol>

The authors declare that they have no competing financial interests.

这个程序允许超声引导下静脉穿刺，并通过正确的supraclaviculare窝视图实时中心静脉导管尖端位置的可视化。与肺部超声扫描相结合，这种方法可以取代胸片确认导管尖端位置，排除气胸的。 这是至关重要的超声波训练有素的操作员熟悉由锁骨上窝视图中提供的超声解剖和正确识别解剖标志。此外，关键的是要调整超声波探头的角度相对于所述颈部以一个可与小的探针来最好?...

中心静脉导管（CVC）尖端位置已得到证实，因为错位导管可导致外伤和血管内皮细胞及血管壁的侵蚀，随后可能致命的心包填塞1。此外，CVC在上部上腔静脉（SVC）可以挑起血栓事件，特别是在癌症患者。同样是在相反的头臂静脉或颈内静脉（IJV）2如此错位CVC。 几种方法已被建立，以确认在​​较低的SVC CVC尖端位置。胸片历来进行的床边方法，以可视化的CVC尖端和排除气胸。然而，附加地暴露于辐射和成本，胸片为前端位置和气胸灵敏度的精度受到质疑，专门为病人在仰卧位3。计算机断层扫描是非常准确和灵敏为CVC吨IP位置和气胸，分别。然而，成本和暴露于辐射并不能证明这种方法对CVC提示确认的唯一指标。经食管超声心动图（TEE）是非常准确的尖端位置，但适应症TEE仅限于患者心脏病理4。心内心电图（ECG）是一个准确的方法，但依赖于P波心律5。 胸骨旁和肋下超声视图被提出来验证CVC末端的位置，但成功取决于导线的深插入到右心房。阴性结果不排除错位导管6,7。右锁骨上窝超声观点在心力衰竭诊断目的已经完全描述。在中试研究中，我们已经证明，这种观点也可安全地用于右颈内静脉的静脉穿刺和CVC导丝随后CVC PL精确定位acement实时8。右锁骨上窝超声视图可以建立与一个microconvex探针相比，线性探针8-10，其具有小尺寸，深pentetration和，但足够的分辨率为静脉穿刺的优点。 所提出的过程有可视静脉穿刺和引导线前进以实时的无菌区域内的单个超声探头的优点。式CVC插入长度不必进行事后更正和额外的操作和潜在的污染源被阻止。在肺超声排除气胸相结合，提出的方法有更换胸片为CVC末端位置确认和排除气胸，降低成本和暴露于辐射和增加任何医院环境患者的舒适度势，其中超声机配备有microconvex超声探头是AVAilable。

<table><tbody><tr><td>Skin disinfectant</td><td>Ecolab</td><td>2686556</td><td>Skinsept G</td></tr><tr><td>8C-RS microconvex probe</td><td>GE Healthcare</td><td>8C-RS</td><td>Any ultrasound machine equipped with a microconvex ultrasound probe should be suitable for this method.</td></tr><tr><td>Logiq e ultrasound machine</td><td>GE Healthcare</td><td>Logiq e</td><td></td></tr><tr><td>CVC kit</td><td>Teleflex Medical</td><td>OW-15802-E</td><td>8 Fr. 2 Lumen Blue-Flex tip catheter</td></tr><tr><td>Sterile gloves</td><td>Protexix</td><td>2D72NT70X</td><td>LatexMicro</td></tr><tr><td>Sterile gown</td><td>Medline</td><td>OP9512CE</td><td>OPS Advanced</td></tr><tr><td>Sterile ultrasound probe cover</td><td>CIVCO</td><td>610-637</td><td>CIV-Fle Transducer Cover; sterile 8.9 x 91.5 cm</td></tr><tr><td>Suture</td><td>Ethicon</td><td>EH7723</td><td>Ethibond</td></tr><tr><td>12L-RS linear ultrasound probe</td><td>GE Healthcare</td><td></td><td>any linear ultrasound probe is suitable for lung ultrasound</td></tr></tbody></table>

the supraclavicular fossa ultrasound view for central venous catheter placement and catheter change over guidewire

锁骨上窝超声视图可用于中心静脉导管（CVC）的位置很有用。颈内静脉（IJV）或锁骨下静脉的静脉穿刺是用微凸超声波探头进行的，使用具有10MHz的探针频率新生儿腹部​​预设在10-12厘米的深度。下列插入导线插入静脉中，探针被移动到右锁骨上窝，以获得上腔静脉（SVC），右肺动脉和升主动脉的图。根据实时超声图，导线和它的J-尖端可视化并向前推到下的SVC。插入深度使用中心静脉导管导丝痕读取。 CVC然后插入下面的皮肤和静脉扩张。锁骨上窝的看法是右颈内静脉插入CVC最合适的。如果其他插入位点都选择了右锁骨上窝应该是无菌区之内。在国际合资扫描，brachiocephaliÇ静脉和SVC可静脉穿刺前显露显著血栓形成。错放的CVC可以与实时超声引导下通过导丝技术的变化进行校正。在诊断肺部超声扫描相结合，这一技术有可能取代胸片确认CVC末端位置，排除气胸的。此外，这种观点是有利的患者的非对 - 波心律是帧内心脏心电图（ECG）是不适合的CVC尖端位置的确认是可行的。该方法的限制是缺乏微凸探针的可用性和需要进行培训。

在先前发表的研究报告，胸片在以下超声引导CVC放置8所有患者获得。相对于胸部X光片隆突CVC末端位置由放射科医生谁证实了CVC在较低SVC在所有调查的患者正确的位置进行分析。在90％的情况下，CVC末端是内隆突为35毫米的距离。在17％的CVC末端是如上所述，在19％时的电平，并在64％的隆突下方。在4％的CVC末端是超过55毫米以下刘嘉玲（ 图1-2）。 <p class="jove_content" fo:keep-toge...

Watch this Scientific Journal Video about The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire at JoVE.com

The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire

总体目标是使临床医生通过上腔静脉的下部的右锁骨上窝以便插入实时超声引导下中央静脉导管。这种观点是不同的导管插入位点有用的，血栓检测错位导管插入和超声引导下修正前。

锁骨上窝超声显示为中心静脉导管放置和导管改过来导丝

The supraclavicular fossa ultrasound view can be useful for central venous catheter (CVC) placement. Venipuncture of the internal jugular veins (IJV) or ...

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18.8K 次观看.  University Hospital Bonn. 总体目标是使临床医生通过上腔静脉的下部的右锁骨上窝以便插入实时超声引导下中央静脉导管。这种观点是不同的导管插入位点有用的，血栓检测错位导管插入和超声引导下修正前。 

视频: The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

A technological platform (MediGuide) has been recently introduced for non-fluoroscopic catheter tracking. In several studies, we have demonstrated that the application of this non-fluoroscopic catheter visualization system (NFCV) reduces fluoroscopy time and dose by 90-95% in a variety of electrophysiology (EP) procedures. This can be of relevance not only to the patients, but also to the nurses and physicians working in the EP lab. Furthermore, in a subset of indications such as supraventricular tachycardias, NFCV enables a fully non-fluoroscopic procedure and allows the lab staff to work without wearing lead aprons. With this protocol, we demonstrate that even complex procedures such as ablations of atrial fibrillation, that are typically associated with fluoroscopy times of &#62;30 min in conventional settings, can safely be performed with a reduction of &#62;90% in fluoroscopy exposure by the additional use of NFCV.

Radiation exposure is an underestimated risk in complex ablation procedures. Here, we describe a protocol to significantly decrease fluoroscopy time and dosage for both the patient and the lab staff by using a novel non-fluoroscopic catheter visualization system.

非透视导管跟踪透视减少介入电

A technological platform (MediGuide) has been recently introduced for non-fluoroscopic catheter tracking. In several studies, we have demonstrated that ...

科研

医学

用于绵羊静脉依从性评估的 3D 血管造影

Quantifying Inferior Vena Cava Compliance and Distensibility in an In Vivo Ovine Model Using 3D Angiography

Synthetic vascular grafts overcome some challenges of allografts, autografts, and xenografts but are often more rigid and less compliant than the native vessel into which they are implanted. Compliance matching with the native vessel is emerging as a key property for graft success. The current gold standard for assessing vessel compliance involves the vessel's excision and ex vivo biaxial mechanical testing. We developed an in vivo method to assess venous compliance and distensibility that better reflects natural physiology and takes into consideration the impact of a pressure change caused by flowing blood and by any morphologic changes present. 
This method is designed as a survival procedure, facilitating longitudinal studies while potentially reducing the need for animal use. Our method involves injecting a 20 mL/kg saline bolus into the venous vasculature, followed by the acquisition of pre and post bolus 3D angiograms to observe alterations induced by the bolus, concurrently with intravascular pressure measurements in target regions. We are then able to measure the circumference and the cross-sectional area of the vessel pre and post bolus. 
With these data and the intravascular pressure, we are able to calculate the compliance and distensibility with specific equations. This method was used to compare the inferior vena cava's compliance and distensibility in native unoperated sheep to the conduit of sheep implanted with a long-term expanded polytetrafluorethylene (PTFE) graft. The native vessel was found to be more compliant and distensible than the PTFE graft at all measured locations. We conclude that this method safely provides in vivo measurements of vein compliance and distensibility.

作者聚焦:先天性心脏病研究中新生血管发育的改进成像

This protocol allows for the in vivo quantification of venous compliance and distensibility using catheterization and 3D angiography as a survival procedure allowing for a variety of potential applications.

使用 3D 血管造影量化体内绵羊模型中的下腔静脉顺应性和扩张性

Synthetic vascular grafts overcome some challenges of allografts, autografts, and xenografts but are often more rigid and less compliant than the native ...

生物工程

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine

Cardiopulmonary resuscitation after cardiac arrest, independent of its origin, is a regularly encountered medical emergency in hospitals as well as preclinical settings. Prospective randomized trials in human subjects are difficult to design and ethically ambiguous, which results in a lack of evidence-based therapies. The model presented in this report represents one of the most common causes of cardiac arrests, ventricular fibrillation, in a standardized setting in a large animal model. This allows for reproducible observations and various therapeutic interventions under clinically accurate conditions, hence facilitating the generation of better evidence and eventually the potential for improved medical treatment.

Cardiopulmonary resuscitation and defibrillation are the only effective therapeutic options during cardiac arrest caused by ventricular fibrillation. This model presents a standardized regimen to induce, assess, and treat this physiological state in a porcine model, thus providing a clinical approach with various opportunities for data collection and analysis.

猪心室颤动和高级心脏生命支持标准化模型

Cardiopulmonary resuscitation after cardiac arrest, independent of its origin, is a regularly encountered medical emergency in hospitals as well as ...

Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava

Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical decision-making. Among the applications of POCUS, imaging the inferior vena cava (IVC) is practiced by a wide variety of specialties, such as nephrology, emergency medicine, internal medicine, critical care, anesthesiology, pulmonology, and cardiology. Although each specialty uses IVC data in slightly different ways, most medical specialties, at minimum, attempt to use IVC data to make predictions about intravascular volume status. While the relationship between IVC sonographic data and intravascular volume status is complex and highly context-dependent, all clinicians should collect the sonographic data in standardized ways to ensure repeatability. This paper describes standardized IVC image acquisition including patient positioning, transducer selection, probe placement, image optimization, and the pitfalls and limitations of IVC sonographic imaging.&#160;This paper also describes the commonly performed anterior IVC long-axis view and three other views of the IVC that can each provide helpful diagnostic information when the anterior long-axis view is difficult to obtain or interpret.

Point-of-care ultrasound evaluation of the inferior vena cava (IVC) is commonly utilized to identify, among other things, the volume status. Imaging should be performed systematically to ensure repeatability. This manuscript reviews the methods and pitfalls of sonographic IVC examination.

一种下腔静脉超声评估的图像采集方法

Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical ...

Intubation, Central Venous Catheter, and Arterial Line Placement in Swine for Translational Research in Abdominal Transplantation Surgery

Translational surgical research models in swine are crucial for developing safe preclinical protocols. However, the success of the experimental surgeries does not solely rely on the research team's surgical skills; perioperative care and management procedures, like intubation, central venous line, and arterial line placement, are necessary and of the utmost importance for favorable experiment results. As it is uncommon for research teams to have anesthesiologists or any other staff other than the surgical team, the surgical team involved in translational research must acquire and/or develop the skills to perform the perioperative care. The purpose of this paper is to show the techniques of intubation, central venous catheter, and arterial line placement used and perfected at the Toronto Organ Preservation Laboratory over the last 10 years, to be used as a reference for future researchers joining either this team or any other lab performing translational research protocols in swine and/or abdominal transplantation.

To obtain the best possible results, surgeons performing translational research experiments should be proficient at intubation and vascular line placement. This paper describes the techniques used by the Toronto Organ Preservation Laboratory to perform these procedures.

Translational surgical research models in swine are crucial for developing safe preclinical protocols. However, the success of the experimental surgeries ...

使用仿真模型培训 POCUS 血管插管的新手

Using Simulation Models to Train Clinicians in the Use of Point-of-Care Ultrasound

The use of point-of-care ultrasound (POCUS) has shown to be a beneficial non-invasive vascular access assessment method by clinicians, which can provide critical elements of visual and measurable information that proves to be useful in the context of vascular access cannulation, in combination with the practical skill of the clinician performing the cannulation. However, the use of POCUS in this context is to practically train and enable individuals who are novices in using this technique to become proficient in performing this task subsequently on patients in a careful and successful way. The simulation of these vascular conditions may be useful to help healthcare professionals learn, understand, apply, and establish such practical skills for vascular cannulation safely to achieve the desired outcomes. This project intended, through the attendance of a half-day workshop, to establish skills to use POCUS in connection with simulation models and perform specific tasks to enable clinicians to use this method in their clinical practice for vascular access cannulation in patients. A mixed-methods longitudinal study design was used to evaluate the effect of a point-of-care ultrasound workshop for peripheral intravenous cannula insertion, including specific tasks for the participants to be performed on simulation models. A total of 81 individuals participated in 11 half-day workshops through 2021 and 2022. Offering a workshop that uses simulation models in combination with various POCUS devices is useful in establishing this newly learned skill in clinicians, such as measurements of depth, caliper, and direction of a vein with POCUS prior to cannulation providing essential anatomical facts to the operator, which increases the likelihood of first-time success in cannulation.

作者聚焦：通过模拟培训评估临床医生对超声引导下血管插管的采用情况

The present protocol describes an ideal solution to train novices in the use of point-of-care ultrasound devices for the practical clinical skill of visually assessing distinct individual anatomical vascular conditions prior to and during an intended venous vascular cannulation using point-of-care ultrasound in a patient.

使用仿真模型培训临床医生使用床旁超声 

The use of point-of-care ultrasound (POCUS) has shown to be a beneficial non-invasive vascular access assessment method by clinicians, which can provide ...

锁骨上窝超声显示为中心静脉导管放置和导管改过来导丝

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非透视导管跟踪透视减少介入电

使用 3D 血管造影量化体内绵羊模型中的下腔静脉顺应性和扩张性

使用 3D 血管造影量化体内绵羊模型中的下腔静脉顺应性和扩张性

使用 3D 血管造影量化体内绵羊模型中的下腔静脉顺应性和扩张性

猪心室颤动和高级心脏生命支持标准化模型

一种下腔静脉超声评估的图像采集方法

Intubation, Central Venous Catheter, and Arterial Line Placement in Swine for Translational Research in Abdominal Transplantation Surgery

使用仿真模型培训临床医生使用床旁超声

使用仿真模型培训临床医生使用床旁超声

使用仿真模型培训临床医生使用床旁超声