Modification of Guide Wire for 22-gauge Safe Guide
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概要
- 論文の詳細を見る
Safe guide is a central venous catheterization kit that serves as both pilot needle and introducer. With a single puncture, a guide wire can be introduced by inserting it through the side port of the 22-gauge needle. The advantage is that this needle can be placed within a blood vessel using no more force than is required to insert a pilot needle. However, the 0.018-inch guide wire is vulnerable to kinks and locking. Because the tip has been shaped into a sharp J-shaped angle, it can kink at the puncture site, and locking sometimes occurs when the guide wire is passed through the side port of the needle, or when the dilator is introduced. In order to resolve these issues, we modified the device by making an experimental guide wire with a gentler angle. In addition, we fortified the body of the wire without altering its thickness. We then investigated the effectiveness of our modifications. The subjects of the study were 120 patients, who required central venous catheterization. They were divided into 2 groups. The original J-type guide wire was used in one group (Group A:n=60) and the modified guide wire in the other group (Group B:n=60). Catheters were introduced by right internal jugular vein puncture. We observed the following: 1) incidence of back-flow appearing at withdrawal of the needle without back-flow during advancement, 2) incidence of kinking or locking of the guide wire when it was passed through the side port, 3) incidence of kinking of the guide wire at the puncture site when introducing the dilator, and 4) complications. The results were as follows: 1) back-flow appeared upon withdrawal in 3.4% of both groups; 2) kinking and locking occurred when passing the guide wire through the side port of the Safe guide needle in 16.7% of Group A and 1.7% of Group B; 3) kinking of the guide wire occurred when introducing the dilator in 5% of Group A in contrast to 0% in Group B; 4) the only complication caused by the passing of the guide wire was accidental puncture of the common carotid artery, which occurred in 1.7% of both groups. No problems with the guide wire were noted in either group. The use of our modified guide wire decreased the incidence of kinking and locking of the guide wire when passing it through the side port. In addition, no guide wire kinking at the puncture site occurred when introducing the dilator. Issues associated with the original J-type guide wire were resolved by 1) changing the guide wire tip to a gentler angle, and 2) fortifying the guide wire by altering its composition.
- 東海大学の論文
著者
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Hasegawa Jun
Department of Anesthesiology, Tokai University School of Medicine
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Suzuki Toshiyasu
Department of Anesthesiology, Tokai University School of Medicine
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Oda Masatoshi
Unisis Corporation
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Takahashi M
Tokai Univ. School Of Medicine
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Suzuki T
Department Of Ophthalmology Tokai University School Of Medicine
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Ito K
Ito Hospital
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Ito Kenji
Department of Research and Development, Yoshida Pharmaceutical Co., Ltd.
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Takahashi M
Department Of Otolaryngology Tokai University School Of Medicine
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NISHIYAMA Junichi
Department of Anesthesiology, School of Medicine, Tokai University
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TAKAHASHI Miwa
Unisys Corp, Ltd.
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TAKIGUCHI Mamoru
Department of Anesthesiology, Tokai University School of Medicine
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ODA Masatoshi
Unisys Corporation
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Suzuki Toshiyasu
Dep. Of Anesthesiology Div. Of Basic Medical Sci. And Molecular Medicine Tokai Univ. School Of Medic
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Takiguchi M
Unisis Corporation
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Suzuki Toshiyasu
Department Of Anesthesiology Discipline Of Surgery Tokai University School Of Medicine
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Hayashi Jun-ichi
Department Of Surgery Japanese Red Cross Nagaoka Hospital
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Takiguchi Mamoru
Department Of Anesthesiology Tokai University School Of Medicine
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Nishiyama J
Department Of Anesthesiology School Of Medicine Tokai University
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Ito Kenji
Department Of Anesthesiology Tokai University School Of Medicine
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Hasegawa Jun
Department Of Anesthesiology Tokai University School Of Medicine
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Nishiyama Junichi
Department Of Anesthesiology Tokai University School Of Medicine
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