Use of sterile saline as a conduction agent for ultrasound visualization of central venous structures

Autor: Ryan Windish, John L. Kendall, Todd C. Ungar, Jason S. Haukoos, Brandon H. Backlund
Rok vydání: 2010
Předmět:
Zdroj: Emergency Medicine Australasia. 22:232-235
ISSN: 1742-6723
1742-6731
DOI: 10.1111/j.1742-6723.2010.01297.x
Popis: Objective: To determine whether sterile saline as a conduction agent provides adequate visualization of anatomic structures to attempt ultrasound-guided vascular access. Methods: This prospective study involved a convenience sample of adult patients (18 years and older) who presented to an urban academic ED during a 3-month study period. Each patient had three six-second ultrasound video clips obtained of the right internal jugular vein and surrounding structures utilizing three different conduction agents, water-based gel (the control), sterile saline or no conduction agent. Video clips were randomized and assigned a numeric code to blind reviewers to the conduction agent. They were then independently reviewed by two experts who determined whether anatomic structures were visualized with enough detail to perform ultrasound-guided vascular access. The reviewers also rated the overall image quality of each video clip using a 100 mm visual analogue scale (VAS). Results: Forty-seven patients were included in the final analysis. The raw agreement was 100% (95% confidence intervals [CI]: 93‐100%) with a kappa of 1.0 between the two reviewers in assessing whether they would be able to perform vascular access using the images obtained using saline as a conduction agent. The median VAS for gel across both reviewers was 92 (95% CI: 90‐93) and the median VAS differences for saline and no medium were ‐3 (95% CI: ‐1 to ‐3) and ‐46 (95% CI: ‐22 to ‐61), respectively. Conclusions: The use of sterile saline as a conduction agent allows adequate visualization of anatomic structures to attempt ultrasound-guided vascular access.
Databáze: OpenAIRE
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