Ultrasound-guided central venous catheterization -

Francisco Matias; Edgar Semedo; Cláudia Carreira; Paula Pereira

doi:10.1016/j.bjane.2014.09.011

Clinical Informations

Ultrasound-guided central venous catheterization - "Syringe-Free" approach

Cateterização venosa central guiada por ultrassom - abordagem "Syringe-Free"

Francisco Matias; Edgar Semedo; Cláudia Carreira; Paula Pereira

http://dx.doi.org/10.1016/j.bjane.2014.09.011 Braz J Anesthesiol, vol.67, n3, p.314-317, 2017

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Abstract

Abstract Background and objectives: Central venous catheterization of the internal jugular vein is a commonly performed invasive procedure associated with a significant morbidity and even mortality. Ultrasound-guided methods have shown to improve significantly the success of the technique and are recommended by various scientific societies, including the American Society of Anesthesiologists. The aim of this report is to describe an innovative ultrasound-guided central line placement of the internal jugular vein. Technique: The authors describe an innovative ultrasound-guided central line placement of the internal jugular vein based on an oblique approach - the "Syringe-Free" approach. This technique allows immediate progression of the guide wire in the venous lumen, while maintaining a real-time continuous ultrasound image. Conclusions: The described method adds to the traditional oblique technique the possibility of achieving a continuous real-time ultrasound-guided venipuncture and a guide wire insertion that does not need removing the probe from the puncture field, while having a single operator performing the whole procedure.

Keywords

Ultrasonography, Interventional, Jugular veins, Catheterization, Central venous, Internal jugular vein cannulation, Oblique view

Resumo

Resumo Justificativa e objetivos: A cateterização venosa central da veia jugular interna é um procedimento invasivo feito frequentemente e associado a morbilidade significativa e até mesmo mortalidade. Os métodos guiados por ultrassonografia têm demonstrado uma melhoria do sucesso desse procedimento e são recomendados por várias sociedades científicas, incluindo a American Society of Anesthesiologists. O objetivo deste artigo é descrever uma abordagem inovadora de cateterização venosa central guiada por ultrassonografia no nível da veia jugular interna. Técnica: Os autores descrevem técnica ecoguiada inovadora de cateterização venosa central da veia jugular interna, baseada numa abordagem oblíqua - a abordagem Syringe-Free. Essa técnica permite uma progressão imediata do fio-guia ao longo do lúmen venoso e manter uma visualização ecográfica em tempo real e contínua. Conclusões: A técnica descrita acrescenta à técnica oblíqua tradicional a possibilidade de, com um único operador, conseguir uma punção venosa central com visualização ecográfica contínua e em tempo real associada à inserção do fio-guia sem necessidade de afastamento do transdutor de ultrassonografia do campo de punção.

Palavras-chave

Ultrassonografia, Intervenção, Veias jugulares, Cateterização, Veia central, Canulação da veia jugular interna, Abordagem oblíqua

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