PDF(Pubmed)
Abstract：
UNASSIGNED: Ensuring safe central venous catheter tip placement is important. Multiple techniques are available to estimate the length of catheter insertion for subclavian and internal jugular approaches. However, the methods to determine the length of insertion for the axillary route have not been validated. The purpose of this feasibility study was to evaluate a simple method for the calculation of catheter length to be inserted and assess whether it accurately predicts the correct tip placement.
UNASSIGNED: A total of 102 patients requiring preoperative central venous cannulation were evaluated, out of which 60 had successful axillary vein (AxV) cannulation. The length of insertion was calculated using the formula: (2/3* A + B) +Y (A: Clavicular length on chest radiograph [CXR], B: Vertical distance between the sternal head and carina on CXR, Y: Perpendicular distance from the skin to the AxV on ultrasound). A postoperative CXR was used to assess the accurate tip placement (2 cm above the carina to 0.5 cm below it). The primary outcome of the study was the rate of successful placement of the central venous catheter (CVC) in terms of the correct position of the tip of the catheter when the length of the catheter inserted was predicted by the formula described previously.
UNASSIGNED: Optimal placement was observed in 83.33% of the cases. A higher rate of accuracy was seen in the females (P value = 0.03) and shorter patients (P value = 0.01). A Bland-Altman plot depicted a high degree of agreement.
UNASSIGNED: Use of the formula using a CXR and ultrasound allowed P successful placement of the CVC tip at the desired location in 83.33% of the cases.
UNASSIGNED: A total of 102 patients requiring preoperative central venous cannulation were evaluated, out of which 60 had successful axillary vein (AxV) cannulation. The length of insertion was calculated using the formula: (2/3* A + B) +Y (A: Clavicular length on chest radiograph [CXR], B: Vertical distance between the sternal head and carina on CXR, Y: Perpendicular distance from the skin to the AxV on ultrasound). A postoperative CXR was used to assess the accurate tip placement (2 cm above the carina to 0.5 cm below it). The primary outcome of the study was the rate of successful placement of the central venous catheter (CVC) in terms of the correct position of the tip of the catheter when the length of the catheter inserted was predicted by the formula described previously.
UNASSIGNED: Optimal placement was observed in 83.33% of the cases. A higher rate of accuracy was seen in the females (P value = 0.03) and shorter patients (P value = 0.01). A Bland-Altman plot depicted a high degree of agreement.
UNASSIGNED: Use of the formula using a CXR and ultrasound allowed P successful placement of the CVC tip at the desired location in 83.33% of the cases.
摘要：
■确保安全的中心静脉导管尖端放置很重要。多种技术可用于估计锁骨下和颈内入路的导管插入长度。然而,确定腋路插入长度的方法尚未得到验证.这项可行性研究的目的是评估一种用于计算要插入的导管长度的简单方法，并评估其是否能准确预测正确的尖端放置。
■共评估了102例需要术前中心静脉置管的患者，其中60例成功进行了腋窝静脉（AxV）插管。使用以下公式计算插入长度：（2/3*AB）Y（A：胸片[CXR]上的锁骨长度，B：CXR上胸骨头和隆突之间的垂直距离，Y:在超声波上从皮肤到AxV的垂直距离)。术后CXR用于评估准确的尖端放置（隆突上方2厘米至下方0.5厘米）。该研究的主要结果是当插入的导管的长度由先前描述的公式预测时,根据导管尖端的正确位置,中心静脉导管(CVC)的成功放置率。
■在83.33%的病例中观察到最佳放置。在女性（P值=0.03）和较短的患者（P值=0.01）中观察到更高的准确率。Bland-Altman的情节描述了高度的一致性。
■使用使用CXR和超声的公式允许在83.33％的病例中将CVC尖端成功放置在所需位置。
■共评估了102例需要术前中心静脉置管的患者，其中60例成功进行了腋窝静脉（AxV）插管。使用以下公式计算插入长度：（2/3*AB）Y（A：胸片[CXR]上的锁骨长度，B：CXR上胸骨头和隆突之间的垂直距离，Y:在超声波上从皮肤到AxV的垂直距离)。术后CXR用于评估准确的尖端放置（隆突上方2厘米至下方0.5厘米）。该研究的主要结果是当插入的导管的长度由先前描述的公式预测时,根据导管尖端的正确位置,中心静脉导管(CVC)的成功放置率。
■在83.33%的病例中观察到最佳放置。在女性（P值=0.03）和较短的患者（P值=0.01）中观察到更高的准确率。Bland-Altman的情节描述了高度的一致性。
■使用使用CXR和超声的公式允许在83.33％的病例中将CVC尖端成功放置在所需位置。
