JOURNAL ARTICLE

Incidence of posterior vessel wall puncture during ultrasound-guided vessel cannulation in a simulated model

Cynthia H Moon, David Blehar, Michael A Shear, Paradis Uyehara, Romolo J Gaspari, Jeremy Arnold, Jeffrey Cukor
Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine 2010, 17 (10): 1138-41
21069895

OBJECTIVES: The incidence of posterior vessel wall puncture (PVWP) during central line placement with possible subsequent injury to structures lying behind the vein is unknown. At times the internal jugular vein lies immediately anterior to the carotid artery rather than lateral to it, leading to potential arterial puncture should the needle pass through the vein completely. The objective of this study is to evaluate the incidence of PVWP during simulated ultrasound (US)-guided vessel cannulation.

METHODS: Enrolled subjects were emergency medicine resident and attending physicians. Subjects performed US-guided venous access on simulated blood vessels within gelatin-based US phantoms. While blinded to the purpose of the study, each subject performed successful cannulation of the vessel on separate phantoms, with wire placement confirmed by expert review of a follow-up US. Each phantom was subsequently deconstructed to manually inspect for PVWP.

RESULTS: Thirty-five subjects with a range of experience in the technique participated, each performing both transverse and long-axis approaches for a total of 70 cannulations. The overall incidence of PVWP was 34% (95% confidence interval [CI] = 22.9% to 45.1%).

CONCLUSIONS: This study found a high incidence of inadvertent PVWP during simulated US-guided vessel cannulation in this model.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
21069895
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"