Document Detail

The incidence of artery puncture with central venous cannulation using a modified technique for detection and prevention of arterial cannulation.
MedLine Citation:
PMID:  9412883     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cannulation of the central circulation is essential for management of patients who require major surgery, and for patients who are critically ill. Arterial puncture is the most frequent complication associated with central venous cannulation, and is potentially fatal. Detection of arterial puncture can be problematic, especially in patients with cyanotic congenital heart disease. METHODS: One thousand eleven consecutive cardiothoracic and vascular surgical patients who required central venous cannulation were studied using a new technique for detection of arterial puncture and prevention of arterial cannulation. This technique involves continuous pressure transduction of the steel introducer needle. Central venous cannulation was attempted in all patients. The sites of attempted catheterizations, number of arterial punctures and cannulations, and the number of successful catheterizations were noted. All patients were treated in accordance with standard anesthetic and surgical techniques in the institution. RESULTS: One thousand one hundred seventy-two central venous catheters were placed. The overall success rate was 99.6%. The incidence of arterial puncture was 9.3% for central venous cannulation attempts of the internal jugular, subclavian, and femoral veins. No arterial cannulation occurred, and none of the patients had significant complications. Congenital heart disease patients had a higher incidence of arterial puncture (14.1%) and a lower rate (96.8%) of successful cannulation. CONCLUSION: Pressure transduction of the steel needle is a useful technique for detecting arterial puncture and preventing arterial cannulation during attempts to achieve central venous cannulation.
W C Oliver; G A Nuttall; F M Beynen; H S Raimundo; J P Abenstein; J J Arnold
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  11     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-01-29     Completed Date:  1998-01-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  851-5     Citation Subset:  IM    
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Aged, 80 and over
Arteries / injuries*
Catheterization, Central Venous / adverse effects*,  methods
Child, Preschool
Infant, Newborn
Middle Aged
Transducers, Pressure
Comment In:
J Cardiothorac Vasc Anesth. 1998 Aug;12(4):495-6   [PMID:  9713745 ]

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