Background

Needle guides for ultrasound-guided internal jugular venous catheterization facilitate successful cannulation. The ability of a needle guide to prevent a posterior vein wall injury which may secondarily induce lethal complications, is unknown. Previous studies showed that a shallow angle of approach may reduce the incidence of posterior wall injuries. We developed a novel needle guide with a shallow angle of approach for ultrasound-guided venous catheterization and examined whether this needle guide reduces the incidence of posterior wall injuries compared to a conventional needle guide and free-hand placement in a simulated vein.

Methods

This study was a randomized crossover-controlled trial. The primary outcome was the rate of posterior vein wall injuries. Participants had a didactic lecture about three ultrasound-guided techniques using the short-axis out-of-plane approach, including free-hand (P-free), a commercial needle guide (P-com), and a novel needle guide (P-sha). The view inside a simulated vein was recorded during venipuncture.

Results

Thirty-five residents participated in this study. Posterior vein wall injuries occurred in 66% using P-free, 60% using P-com, and 0% using P-sha (p< 0.01). There was no significant difference in the incidence of posterior vein wall injuries between P-free and P-com.

Conclusions

Use of a shallow angle of approach needle guide resulted in a lower rate of posterior vein injuries during venipuncture of a simulated vein compared with other techniques using a steeper angle techniques.

中文翻译：

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超声引导颈内静脉插管的浅角度针头引导器：随机对照交叉模拟研究（CONSORT）。

背景

超声引导颈内静脉插管的针头引导器有助于成功插管。导针器防止可能继发性致死并发症的后静脉壁损伤的能力尚不清楚。先前的研究表明，浅入路可以减少后壁损伤的发生。我们开发了一种用于超声引导静脉导管插入的具有较小进角角度的新型导针器，并检查了该导针器与传统的导针器和徒手放置在模拟静脉中相比，是否可减少后壁损伤的发生。

方法

这项研究是一项随机交叉对照试验。主要结局是后静脉壁损伤的发生率。参与者进行了关于三种使用短轴平面外方法的超声引导技术的教学讲课，包括徒手（P-free），商用针头引导器（P-com）和新型针头引导器（P -sha）。在静脉穿刺期间记录了模拟静脉内的视图。

结果

三十五名居民参加了这项研究。使用无磷时，后静脉壁损伤发生率为66％，使用P-com时为60％，使用P-sha时为0％（p <0.01）。无P型和P型com之间后静脉壁损伤的发生率无显着差异。

结论

与使用较陡峭角度技术的其他技术相比，使用浅角度的进针引导器在模拟静脉静脉穿刺期间导致后静脉损伤的发生率较低。