Name: the supraclavicular fossa ultrasound view for central venous catheter placement and catheter change over guidewire
Uploaded: 2014-12-23T14:00:00
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?...

<ol>
	<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>

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 border="0" cellpadding="0" cellspacing="0" width="1058">
	<tbody>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Name of Material/ Equipment</td>
			<td style="width:93px;">Company</td>
			<td style="width:119px;">Catalog Number</td>
			<td style="width:631px;">Comments/Description</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">skin desinfection</td>
			<td style="width:93px;">Ecolab</td>
			<td align="right" style="width:119px;">2686556</td>
			<td>Skinsept G</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;">8C-RS microconvex probe</td>
			<td style="width:93px;">GE Healthcare</td>
			<td style="width:119px;">8C-RS</td>
			<td>Any ultrasound machine equipped with a microconvex ultrasound probe should be suitable for this method</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Logiq e ultrasound machine</td>
			<td style="width:93px;">GE Healthcare</td>
			<td style="width:119px;">Logiq e</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">CVC Kit</td>
			<td style="width:93px;">Teleflex Medical</td>
			<td style="width:119px;">OW-15802-E</td>
			<td>8 Fr. 2 Lumen Blue-Flex tip catheter</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Sterile gloves</td>
			<td style="width:93px;">Protexix</td>
			<td style="width:119px;">2D72NT70X</td>
			<td>LatexMicro</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Sterile gown</td>
			<td style="width:93px;">Medline</td>
			<td style="width:119px;">OP9512CE</td>
			<td>OPS Advanced</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">sterile ultrasound probe cover</td>
			<td style="width:93px;">CIVCO</td>
			<td style="width:119px;">610-637</td>
			<td>CIV-Fle Transducer Cover; sterile 8.9 x 91.5 cm</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">suture</td>
			<td style="width:93px;">Ethicon</td>
			<td style="width:119px;">EH7723</td>
			<td>Ethibond</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">12L-RS linear ultrasound probe</td>
			<td style="width:93px;">GE Healthcare</td>
			<td style="width:119px;"></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 ...

Research

JoVE Journal

Medicine

Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures

遥控磁导航导管定位准确，实时和心脏电生理消融程序

New remote navigation systems have been developed to improve current limitations of conventional manually guided catheter ablation in complex cardiac ...

科研

医学

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

结合消融房颤左心耳封堵

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting millions of individuals worldwide 1-3. The rapid, irregular, and ...

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

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 ...

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

采用多极导管三维测图系统进行缺血性室性心动过速的高密度电解剖重建

Ventricular tachycardia (VT) in patients with ischemic cardiomyopathy mainly results from endocardial scars after myocardial infarction; those scars ...

Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis

中央静脉狭窄病的Murine模型,使用具有流出狭窄病的动脉静脉瘘管病

Central venous stenosis is an important entity contributing to arteriovenous fistula (AVF) failure. A murine AVF model was modified to create a partial ...

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit

在重症监护病房的中央静脉导管上设置无针接头,带正位移

Needle-free connectors were initially designed and promoted to avoid blood exposure for healthcare workers. Some recent data suggest that the latest ...

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

一种小鼠腹膜透析导管放置的逆行植入方法

Murine models are employed to probe various aspects of peritoneal dialysis (PD), such as peritoneal inflammation and fibrosis. These events drive ...

Drug Treatment by Central Venous Catheter in a Mouse Model of Angiotensin II Induced Abdominal Aortic Aneurysm and Monitoring by 3D Ultrasound

血管紧张素II诱导的腹主动脉瘤小鼠模型中中心静脉导管的药物治疗及3D超声监测

Since pharmaceutical treatment options are lacking in the clinical management of abdominal aortic aneurysm (AAA), animal models, in particular mouse ...

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge

负荷前激发期间的连续静脉动脉多普勒超声检查

A preload challenge (PC) is a clinical maneuver that, first, increases the cardiac filling (i.e., preload) and, second, calculates the change in cardiac ...

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

下肢近端深静脉血栓形成的即时超声筛查

Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening ...