رسالة جامعية
Cathétérisme central de la veine axillaire : une étude de simulation prospective randomisée contrôlée, comparant l'échoguidage standard et un nouveau dispositif de pilote d'aiguille
| العنوان: | Cathétérisme central de la veine axillaire : une étude de simulation prospective randomisée contrôlée, comparant l'échoguidage standard et un nouveau dispositif de pilote d'aiguille |
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| المؤلفون: | Boulet, Nicolas |
| المساهمون: | Thèses d'exercice et mémoires - UFR de Médecine Montpellier-Nîmes, Université de Montpellier (UM), Laurent Muller |
| المصدر: | https://dumas.ccsd.cnrs.fr/dumas-03658113Test ; Human health and pathology. 2022. |
| بيانات النشر: | HAL CCSD |
| سنة النشر: | 2022 |
| المجموعة: | DUMAS (Dépôt Universitaire de Mémoires Après Soutenance) |
| مصطلحات موضوعية: | Needle-pilot device, Simulation, Ultrasound guidance, Dispositif de pilote d'aiguille, Veine sous-clavière, Échoguidage, MESH: Catheterization, central venous, MESH: Axillary vein, MESH: Subclavian vein, MESH: Cathétérisme veineux central, MESH: Simulation, MESH: Veine axillaire, MESH: Échographie, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | Background: real-time ultrasound (US) guidance facilitates central venous catheterization in intensive care unit (ICU). New magnetic needle-pilot devices could improve efficiency and safety of central venous catheterization. This simulation trial was aimed at comparing venipuncture with a new needle-pilot device to conventional US technique. Methods: in a prospective, randomized, simulation trial, 51 ICU physicians and residents cannulated the right axillary vein of a human torso mannequin with standard US guidance and with a needle-pilot system, in a randomized order. The primary outcome was the time from skin puncture to successful venous cannulation. The secondary outcomes were the number of skin punctures, the number of posterior wall puncture of the axillary vein, the number of arterial punctures, the number of needle redirections, the failure rate and the operator comfort. Results: time to successful cannulation was shorter with needle-pilot US-guided technique (22 s (interquartile range (IQR) = 16-42) versus 25 s (IQR = 19-128); median of difference (MOD) = - 9 s (95%-confidence interval (CI) - 5; - 22), p < 0.001). The rates of skin punctures, posterior wall puncture of axillary vein, and needle redirections were also lower (p < 0.01). Comfort was higher in needle-pilot US-guided group on a 11-points numeric scale (8 (IQR = 8-9) versus 6 (IQR = 6-8), p < 0.001). Conclusions: in a simulation model, US-guided axillary vein catheterization with a needle-pilot device was associated with a shorter time of successful cannulation and a decrease in numbers of skin punctures and complications. The results plea for investigating clinical performance of this new device. ; Contexte : en réanimation, le cathétérisme veineux central est facilité par l’échoguidage. Cependant, le taux de complications immédiates reste non négligeable. De nouveaux dispositifs magnétiques d’aide au maniement de l'aiguille sous échographie pourraient améliorer l'efficacité et la sécurité de la cathétérisation veineuse centrale. ... |
| نوع الوثيقة: | master thesis |
| اللغة: | English |
| العلاقة: | dumas-03658113; https://dumas.ccsd.cnrs.fr/dumas-03658113Test; https://dumas.ccsd.cnrs.fr/dumas-03658113/documentTest; https://dumas.ccsd.cnrs.fr/dumas-03658113/file/BOULET_Nicolas_th%C3%A8se_biff%C3%A9.pdfTest |
| الإتاحة: | https://dumas.ccsd.cnrs.fr/dumas-03658113Test https://dumas.ccsd.cnrs.fr/dumas-03658113/documentTest https://dumas.ccsd.cnrs.fr/dumas-03658113/file/BOULET_Nicolas_th%C3%A8se_biff%C3%A9.pdfTest |
| حقوق: | http://creativecommons.org/licenses/by-nc-saTest/ ; info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.3D6B04C8 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |