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Objective: To investigate the success rate and safety of modified Seldinger technique (MST) in implementing jugular vein catheterization under ultrasound-guided. Methods: 300 patients who prepared to receive jugular vein catheterization were divided into observation group (n=150 ) and control group (n=150). The patients of observation group were implemented jugular vein catheterization by using MST under ultrasound-guided, and that of control group were implemented conventional technique to achieve jugular vein catheterization. The effect of jugular vein catheterization, complication and satisfaction of patients between the two groups were compared and researched. Results: The success rates of catheterization in one time and total catheterization of observation group were significantly higher than that of control group (t=4.925, t=4.623, P<0.05). The puncture time of observation group was significantly lower than that of the control group (t=10.432, P<0.05). The incidences of bleeding at puncture point, phlebitis, catheter-related infection, and blocked catheter of the observation group were significantly lower than those of the control group (t=5.684, t=5.556, t=4.623, t=4.624, P<0.05), respectively. For puncture, the satisfaction of patients of observation group was significantly higher than that of control group (Z=-2.734, P<0.05). Besides, the incidence of venous thrombosis and unplanned extubation of the observation group was not significant difference with that of the control group. Conclusion:The jugular vein catheterization by using MST under ultrasound-guided can significantly increase the success rate of catheterization, reduce puncture complications and enhance satisfaction of patient.
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Objective To investigate the clinical effect of adopting B-type ultrasound guided peripherally inserted central catheter (PICC) in the patients with lung cancer.Methods Two hundreds and ninety-five cases of lung cancer undergoing PICC in our hospital from January 2011 to May 2016 were selected as the research subjects and divided into the observation group (151 cases) and control group (144 cases) according to the PICC methods.PICC in the observation group adopted the B-type guided modified Seldinger technique,while the control group adopted the conventional method.The venous thrombus occurrence situation in the two groups was comparatively analyzed.Results (1) The platelet count (PLT),plasma D dimer (D-D) and thromboxane B2 (TXB2),endothelin (ET),6-keto-prostaglandin F1 alpha (6-keto-PGF1α) before PICC had no signigicant difference between the two groups (P>0.05).PLT,D-D,TXB2 and ET at 12,24 h after PICC in the observation group and control group were gradually increased,while plasma 6-keto-PGF1α was gradually decreased,the intra-group difference among different time points had statistical significant (P<0.05).PLT and plasma D-D,TXB2 and ET in the observation group were significantly lower than those in the control group,while keto-PGF1α was significantly higher than that in the control group,the difference between the two groups was statistically significant(P<0.05).(2)The incidence rate of venous thrombosis in the observation group was significantly lower than that in the control group,the difference was statistically significant between the two groups (P<0.05).Conclusion Adopting B-type ultrasound guided modified Seldinger technique for PICC in the patients with lung cancer has much lower incidence rate of venous thrombosis.
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Objective To share our experience in the placement of a peripherally inserted central cathe -ter ( PICC) in critically ill patients intensive care unit ( ICU) .Method The clinical data of a critically ill pa-tient placed with PICC from neurosurgery department were collected and analyzed .Result A 78-year-old male patient diagnosed with type I respiratory failure , aspiration pneumonia , hypertension , and cerebral infarction sequelae successfully received ultrasound-guided modified Seldinger puncture technique for PICC and was trea-ted with intravenous nutrition after repeatedly vascular puncturing failure .Conclusion PICC placement is an effective method for patients in ICU to protect the peripheral vein and lower the incidence of catheter related in -fections.
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Objective To explore the application of ultrasound- guide modified Seldinger technique for upper arm PICC insertion in infant patients. Methods Use the ultrasound-guide modified Seldinger technique to inserted PICC for 27 infant patients. Results All 27 cases were inserted successfully, success rate of the one puncture reached 92.6%. Conclusions By adequate preparation for infants, effective immobilization and good cooperation of operators, and combined with techniques which prevent PICC misplacement, overcome the shortcoming of bad vessel and non-compliance of infant patients, develop the advantage of ultrasound, could improve the rate of successful catheterization of upper arm PICC insertion in infant patients, and protect the vessels.
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Objective To investigate training of the ultrasound-guided modified Seldinger technique(MST)for cannulation of PICC.Method Twenty-nine nurses trained with the traditional training on ultrasound-guided MST during December 2009 to December 2011 were set as control group and another 29 nurses trained with the systematic training during December 2011 to December 2013 were as experiment group.The training effect were compared between the two groups after 2 months training.Results The theoretical knowledge in the experiment group was improved significantly compared with the control group. Moreover, the success rate of catheterization in the experiment group was 100.0%,significantly higher than that in the control group(both P<0.01).Conclusion Systematic training system is more effective than the traditional training.It can improve the nurses’technical and theoretical knowledge on ultrasound-guided MST for PICC.
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ObjectiveTo investigate the applicability and superiority of modified Seldinger technique (MST).MethodsTotally 108 patients receiving peripherally inserted central catheter (PICC) through vascular ultrasound combined with MST technology were enrolled as MST group and another 108 patients receiving PICC using traditional direct vision method as control group.The first puncture success rate,PICC succesa rate,catheterization time required,and early complication rate were compared between these two groups.ResultsThe first puncture success rate was 88.89％ in MST group and 72.22％ in control group (P=0.002) ; the catheterization success rate was 82.41％ in MST group and 57.41％ in control group ( P =0.000).In the MST group,there were two cases where the catheter within neck was ectopic ( P =0.003 ),two cases experienced bleeding at the puncture sites (P =0.017),three cases had phlebitis (P =0.001 ),and one case suffered from catheter blockage (P=0.010).In the eontrol group,the corresponding numbers were 13,10,18,and 9.However,the time required for PICC showed no significant difference between these two groups (P=0.685).In the MST group,15 cases were catheterized in less than 15 minutes,72 cases between 15 and 25 minutes,and 21 cases for more than 25 minutes.In the control group,12 cases were catheterized in less than 15 minutes,70 cases between 15 and 25 minutes,and 26 cases for more than 25 minutes.ConclusionPICC through MST can be more effective in positioning the targeting blood vessels,increasing the success rate of catheter insertion,reducing various tissue damages,and lowering potential complications.
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Objective To investigate the common problems and countermeasure of using ultrasound-guided modified Seldinger technique in peripherally inserted central catheter (PICC) placement Method The clinical data of 140 patients who underwent PICC placement using ultrasound-guided modified Seldinger technique were retrospectively analyzed. Results The success rate of catheterization was 98. 6% among these 140 patients,with 135 (96. 4% ) succeeded after a single attempt and 5 (3. 6% ) after 2 attempts. Besides, 7. 1% (n = 10) had difficulty in inserting the guide wire, 3. 6% (n =5) had difficult catheteration, 2. 1% (n =3) met resistance when inserting catheter into ipsilateral subclavian vein, 2. 1 % (n = 3 ) experienced dystopia of inserting catheter into internal jugulular vein, and 1.4% (n = 2) experienced the bending of PICC in the superior vena cava and axillary vein. All of these problems were handled successfully. Conclusions The common problems of PICC placement include puncture failure, difficulty in inserting guide wire, and difficult catheteration. A good knowledge of these problems will help increase the success rate.
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Intubation of an double-lumen endotracheal tube (DLT) in either a normal or a difficult airway may be more difficult than the intubation of a single-lumen endotracheal tube (ETT). A 72-year-old man undergoing right upper lobectomy could not be intubated with either a 37 Fr or a 35 Fr DLT after induction of anesthesia due to an inability to visualize the glottis. Difficult intubation had not been foreseen, but inspection through the laryngoscope revealed a Cormack grade III condition. Following two attempts to place the DLT, fibroptic bronchoscopy also proved unsuccessful. We intubated a 8.0 mm ETT with OELM (optimal external laryngeal manipulation) and followed this by inserting an infusion set catheter into the ETT as a guiding stylet. The ETT was then withdrawn with the catheter in situ in the trachea, and a 35 Fr DLT successfully introduced. After removing the catheter, the position of the DLT was corrected by fibroptic bronchoscopy. No further complication occurred and surgery was finished satisfactory. We achieved successful DLT intubation using the modified Seldinger technique with an infusion set catheter through an intubated ETT in a patient with an unanticipated difficult airway.