Erschienen in:
01.01.2012 | Images in Anesthesia
Point-of-care transthoracic echocardiography as an alternative to transesophageal echocardiography to confirm internal jugular guidewire position
verfasst von:
Ramiro Arellano, MD, Aliya Nurmohamed, Amir Rumman, BSc, Brian Milne, MD, Robert Tanzola, MD
Erschienen in:
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
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Ausgabe 1/2012
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Excerpt
Unintentional needle puncture of the carotid artery (CA) during internal jugular vein (IJV) cannulation occurs relatively frequently.
1 Serious sequelae (e.g., hematoma, airway compromise, stroke, and death) usually occur when this error is not detected, and the CA is subsequently dilated with the large-bore introducer sheath. Methods employed to detect CA puncture include blood colour and flow characteristics, manometry, and pressure transduction of the needle. Ultrasonographic visualization of the IJV and CA prior to cannulation is endorsed as a method to improve safety.
2 However, this technology does not completely eliminate accidental CA injury. Ultrasonography of the neck visualizes the guidewire for only a short distance, leaving room for posterior vein wall penetration outside the field of view. …