床边超声波在皮肤通道气管切除术中的实用性
Simon Meredith1, Zein Kattih1, Brenda Garcia1
1Division of Pulmonary, Sleep & Critical Care Medicine, Lenox Hill Hospital/Northwell Health, New York, NY, USA.
Journal of intensive care medicine
|November 6, 2023
概括
术前的部超声波用于穿皮气管切除术 (PCT) 的放置是常见的. 在超声波上可视化的小部前静脉 (≤3.9mm) 在PCT期间或之后不会显著增加出血风险.
科学领域:
- 临界护理医学 临界护理医学
- 医疗成像医学成像
- 手术手术手术手术手术手术手术手术手术
背景情况:
- 透皮气管切除术 (PCT) 是常见的重症监护室手术.
- 前超声波是PCT前常用的,用于评估血管性和程序安全性.
- 在PCT放置期间和之后,出血并发症是令人担忧的.
研究的目的:
- 为了调查是否程序前超声波识别的前部血管系统在床边PCT期间和之后影响出血风险.
- 为了确定可视化的血管对在床边进行PCT的决定的影响.
主要方法:
- 对接受床边PCT的患者进行前性观察队列研究.
- 术前超声波以确定解剖学标志和血管结构.
- 盲人专家小组对超声波图像进行审查,以评估决策影响.
主要成果:
- 只有7%的患者经历了最小的,临床上无意义的手术内出血.
- 没有患者有术后出血.
- 对于临床PCT决策的专家之间的操作员间变异性很低 (0.214).
结论:
- 在前超声波中可视化的小静脉结构 (≤3.9mm) 在PCT中不会显著增加出血风险.
- 静脉的超声检测结果可能导致不必要地放弃床边PCT.
- 床边PCT可以安全地执行,即使可视化了小静脉.
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