Valsalva Maneuver Prevents Guide Wire Trouble Associated with 22-Gauge Safe guide^<[○!R]>

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概要

• 論文の詳細を見る

• The Safe guide^<[○!R]> is a central venous puncture needle that serves as both a pilot needle and as an introducer. A guide wire can be inserted into a vein through the side port at the hub of the 22-gauge Safe guide^<[○!R]> needle initially inserted as a pilot needle. However, guide wire insertion may fail due to kinking or locking at the side port. Increasing airway pressure to 20cm H_2O by squeezing a respiratory bag during insertion of the guide wire together with venous puncture was attempted to determine if would decrease guide wire trouble. Subjects and methods: A total of 120 patients scheduled for central venous catheterization by right internal jugular puncture were divided into two groups. Patients in group-A (n=60) were catheterized by the conventional method and those in group-B (n=60) were catheterized by applying the Valsalva maneuver. Three observations were made: 1) Frequency of cases in which blood back-flow occurred during withdrawal only and not upon advancement of the puncture needle. 2) Frequency of cases in which kinking and/or locking of the guide wire occurred at the hub during its insertion. And 3) the occurrence of complications. Results: 1) The patency of the vein was preserved and blood back-flow was obtained during advancement of the puncture needle in all cases in which the Valsalva maneuver was applied. 2) The incidence of kinking and/or locking during insertion of the guide wire decreased from 16.7% to 3.4% by applying positive airway pressure during the Valsalva maneuver. And 3) complications were negligible. Additionally, the application of the Valsalva maneuver allowed successful guide wire insertion in 6 out of 9 cases (67%) in group-A, in which the initial attempt using the conventional method had failed. Conclusion: The application of positive airway pressure using the Valsalva maneuver may prevent the guide wire trouble associated with the 22-gauge Safe guide^<[○!R]>.

• 東海大学の論文

著者

• Hasegawa Jun

  Department of Anesthesiology, Tokai University School of Medicine

• Suzuki Toshiyasu

  Department of Anesthesiology, Tokai University School of Medicine

• Takahashi M

  Tokai Univ. School Of Medicine

• TAKEYAMA KAZUHIDE

  Department of Anesthesiology, Tokai University School of Medicine

• Suzuki T

  Department Of Ophthalmology Tokai University School Of Medicine

• NISHIYAMA Junichi

  Department of Anesthesiology, School of Medicine, Tokai University

• TAKIGUCHI Mamoru

  Department of Anesthesiology, Tokai University School of Medicine

• Suzuki Toshiyasu

  Dep. Of Anesthesiology Div. Of Basic Medical Sci. And Molecular Medicine Tokai Univ. School Of Medic

• Takiguchi M

  Unisis Corporation

• Suzuki Toshiyasu

  Department Of Anesthesiology Discipline Of Surgery Tokai University School Of Medicine

• Hayashi Jun-ichi

  Department Of Surgery Japanese Red Cross Nagaoka Hospital

• Takeyama K

  Tokai Univ. School Of Medicine Kanagawa Jpn

• Takeyama Kazuhide

  Department Of Anesthesiology Discipline Of Surgery Tokai University School Of Medicine

• Takiguchi Mamoru

  Department Of Anesthesiology Tokai University School Of Medicine

• Nishiyama J

  Department Of Anesthesiology School Of Medicine Tokai University

• Hasegawa Jun

  Department Of Anesthesiology Tokai University School Of Medicine

• Nishiyama Junichi

  Department Of Anesthesiology Tokai University School Of Medicine

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