对于急诊室难以进入的难以进入的单平面和双平面超声波方法 - 一个随机试验
Davide Enrici Baion1, Alberto La Ferrara1, Davide Maserin1
1Emergency Department, Città della Salute e della Scienza di Torino, Molinette Hospital, 10126 Turin, Italy.
The American journal of emergency medicine
|September 29, 2023
概括
超声波 (US) 有效地帮助外周静脉注射 (PIV) 导管插入困难的血管接入 (PDVA) 病例. 双平面成像在急诊室的PIV成功率方面没有显示出与单平面成像相比的显著优势.
科学领域:
- 紧急医疗 紧急医疗
- 医疗成像医学成像
- 血管接入 血管接入
背景情况:
- 周围静脉注射 (PIV) 导管插入是急性护理中常见的侵入性手术.
- 难以进入血管 (PDVA) 带来了挑战,可能会延迟关键药物管理.
- 超声波 (美国) 越来越多地用于改善PIV管成功.
研究的目的:
- 为了比较双平面与单平面超声波成像对PDVA患者PIV管的疗效.
- 为了确定双平面成像是否在急诊部 (ED) 提供更高的第一次尝试成功率.
主要方法:
- 进行了一项单中心随机对照试验.
- 在ED需要PIV管的成年患者被随机分配到单平面或双平面US指导.
- 主要结局是PIV安置的第一次尝试成功率.
主要成果:
- 总共注册了442名患者.
- 第一次尝试的总体成功率为70.8%.
- 在双平面 (73.3%) 和单平面 (68.3%) 成像 (p=0.395) 之间没有观察到成功率的显著差异. 然而,双平面成像与较短的中位数手术时间有关 (35s vs 45s,p=0.03).
结论:
- 超声波是PIV管在EDPDVA患者的宝贵工具.
- 与PIV插入的单平面成像相比,双平面超声波成像没有显示出第一次尝试成功率的显著改善.
- 虽然没有提高成功率,但双平面成像可能会提供更快的手术时间.
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