Dynamic variation of the axillary veins due to intrathoracic pressure changes: A prospective sonographic study.

CONCLUSIONS: Anatomical variations in depth and diameter as well as the collapsibility due to intrathoracic pressures changes represent common challenges that face clinicians during central venous catheterization of the axillary vein. A noteworthy increase in vessel size as patients transition from spontaneous to mechanical ventilation may theoretically improve first-pass cannulation success with practitioners skilled in both ultrasound and procedure. As a result, placing a centrally inserted central catheter after the induction of anesthesia may be beneficial. PMID: 31204560 [PubMed - as supplied by publisher]
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research

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The authors compared the occurrence of posterior wall puncture using the short-axis out-of-plane and long-axis in-plane approaches with that using the combined short-axis-and-long-axis approach that the authors previously showed to be effective in observational and manikin studies.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
ConclusionUnder general anesthesia several factors such as hypotension can mask the signs of subclavian artery injury. This case indicates that clinicians should be aware of the complications of central venous catheterization and take prompt action.ResumoJustificativa e objetivosA cateterização da veia jugular interna guiada por ultrassom é um procedimento comum e geralmente seguro em sala de cirurgia. No entanto, a punção inadvertida de uma artéria não compressível, como a artéria subclávia, embora rara, pode estar associada a sequelas com risco para vi...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
Ultrasound guidance for central venous catheterization is a commonly used alternative to the conventional landmark method. Because from the German perspective, the cost-effectiveness of ultrasound guidance is ...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
Abstract Accumulating evidence shows that ultrasound (US) guidance improves effectiveness and safety of central venous catheter (CVC) placement. Several international guidelines therefore recommend the use of US for placement of CVCs. However, surveys show that the landmark-based technique is still widely used, while the percentage of physicians using US is increasing less than expected. The goal of this study was to investigate current practice for central venous catheterization in anaesthesiology and intensive care in the Netherlands, identify barriers for further implementation of US guidance and to evaluate wh...
Source: Pain Physician - Category: Anesthesiology Authors: Tags: J Clin Monit Comput Source Type: research
Visualizing the needle tip using the short-axis out-of-plane (SA-OOP) ultrasound-guided central venous catheterization approach is difficult and results in posterior wall puncture (PWP). To improve needle tip visualization in the long-axis view, combining the SA-OOP and the long-axis in-plane approaches has been suggested. The authors, who previously reported on the utility of this technique using a manikin model, examined the feasibility of this novel method (referred to as the combined short-axis and long-axis [CSLA] approach) and compared the CSLA approach with the SA-OOP approach in humans for the present study.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
The role of intraoperative vascular ultrasound continues to evolve in the present era. The indications are ever increasing, ranging from vascular access, central venous catheterization to both central (epiaortic scanning) and peripheral arterial access for establishment of cardiopulmonary bypass (CPB) and cerebral perfusion in extensive aortic dissections. Safe arterial cannulation during repair of Stanford type A aortic dissection with branch vessel involvement, thereby perfusing the organs intraoperatively, is pivotal for a favorable outcome.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Editor —Central venous catheterization for patients positioned prone poses challenges to the anaesthesiologist, such as anatomical restrictions in head and neck position, lack of anatomical landmark points to approach, and difficult right internal jugular vein (RIJV) needle advancement with the left hand . Here we present an approach for RIJV catheterization in a patient positioned prone using in-plane needle ultrasound guidance.
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research
AbstractIn ultrasound-guided central venous catheterization, there is no standard technique either for the needle tip visualization or for the adequate needle angle and entry to the skin with short-axis view under out-of-plane technique. In the present study, we propose a novel technique named “stepwise flashing with triangulation”, and the efficacy of this technique is assessed. Before and after a didactic session in which the technique was explained, 12 novice residents were asked to position the needle tip on or into the imitation vessels and to avoid deeper penetration by using an agar tissue phantom with u...
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
Editor—Ultrasound guidance decreases the complication rate and increases first-pass success of central venous catheter (CVC) placement, a common procedure in anaesthesia and intensive care units, compared with traditional landmark techniques.1 Accordingly, use of ultrasound guidance is recommended for CVC placement.2 Video-based learning (VBL) and lecture-based learning (LBL) are widely used for training residents, but which approach is more effective remains unclear.
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research
Abstract ObjectiveTo report a case of successful surgical removal of a guide wire lost during central venous catheterization. Case SummaryA 28 kg, 4‐year‐old female neutered mixed breed dog presented to the primary care veterinarian with diabetic ketosis. During the process of central venous catheterization, the guide wire was accidently released and the entire length of the guide wire slipped into the jugular vein. Due to the absence of nearby interventional radiology facilities, surgical intervention was proposed. An ultrasound was used to determine that the guide wire was located in the caudal vena cava extending ca...
Source: Journal of Veterinary Emergency and Critical Care - Category: Veterinary Research Authors: Tags: Case Report Source Type: research
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