title: [Continuous guidance for venous punctures using a new pulsed Doppler probe: efficiency, safety].
abstract: Serious complications may occur after "blind" profound venous puncture in intensive care units. To secure these punctures, we designed a new fingertip pulsed Doppler (FPD) 5 MHz probe with a lateral to center indentation to guide the needle into the ultrasonic flux. A specific ultrasound analyzer indicating depth and diameter of the vessel was made for this use. The material was first tested in an experimental animal study. Results of animal venous punctures were successful 20/21. This material was then tested on patients with previous failure of "blind" punctures: results of 4 FPD punctures were successful in all 12 cases but one (catheterization not completed). We started a prospective multi-unit randomized study with various operators (junior residents, senior staff members), compared the success rate and type, the procedure duration of blind standard versus FPD punctures. We conclude in the safety and easy use of the FPD for central venous punctures.
authors.affiliation: Service de Médecine C et de Néphrologie, Centre Hospitalo-Universitaire de Nîmes.
authors.forename: B
authors.initials: B
authors.lastname: Branger
authors.forename: B
authors.initials: B
authors.lastname: Zabadani
authors.forename: F
authors.initials: F
authors.lastname: Vecina
authors.forename: J M
authors.initials: JM
authors.lastname: Juan
authors.forename: M
authors.initials: M
authors.lastname: Dauzat
mesh_terms: D000818:Animals; D002405:Catheterization, Central Venous; D002408:Catheters, Indwelling; D003422:Critical Care; D004867:Equipment Design; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D011446:Prospective Studies; D011677:Punctures; D011817:Rabbits; D006435:Renal Dialysis; D012449:Safety; D013350:Subclavian Vein / Q000000981:diagnostic imaging*; D014159:Transducers; D014463:Ultrasonography; D014684:Venae Cavae / Q000000981:diagnostic imaging
vernacular_title: Guidage continu des ponctions veineuses par une nouvelle sonde Doppler pulsée: efficacité, sécurité.