Guiding significance of latex-tube puncture experiment on subclavian vein catheterization

Yang Bao-sheng; Qian Chuan-yun

doi:10.3969/j.issn.1002-1949.2018.02.010

Abstract：Objective To explore the influence of the following 5 factors on subclavian vein (SCV) catheterization,including angle between needle and SCV, different position of puncture needle into SCV(near the anterior wall,the central or the posterior wall of vessel),depth of needle into SCV, puncture direction (pointed to the horizontal branch or to the corner of SCV and brachiocephalic vein), as well as the curvature between SCV and brachiocephalic veins. Methods Foursizes of latex-tube with a internal diameter of 6 mm,8 mm,10 mm and 12 mm were filled with water,followed by ligation at both ends. Under the traction of threads and the fixation of thestools,an angle and shape similar with SCV and brachiocephalic vein were formed. Subsequently,the puncture and placement of guide wire was performed according to different levels of the 5 factors. Results Guide wire placement was failed when the acute angle between puncture needle and latex tube exceeded a certain angle although puncture was successfully performed. The angle was positively correlated with the resistance of wire placement (P<0.001). Wire placement was more easily performed when puncture needle was near the inferior wall of latex tube than near the superior wall(P<0.001). Guide wire placement was easy to fail when puncture direction pointed to the corner of latex tube. When puncture direction was pointed to the horizontal branch of latex tube,camber size between the horizontal branch and descending branch of latex tube had no effect on wire placement. Conclusion In clinical practice, under the premise that SCV can be reached,the angle between puncture needle and SCV should be as small as possible. The method of positioning puncture site in the opposite directionand the method ofintermittent needle entry have some advantages.