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Chaim Mandelbaum - One of the best experts on this subject based on the ideXlab platform.

Yaakov Beilin - One of the best experts on this subject based on the ideXlab platform.

Kyo Sang Kim - One of the best experts on this subject based on the ideXlab platform.

  • A New Landmark Using the Clavicular Head of the Sternocleidomastoid Muscle for Infraclavicular Subclavian Vein Catheterization
    Korean Journal of Anesthesiology, 2002
    Co-Authors: Jung Kook Suh, Mi Ae Cheong, Jeong Woo Jeon, Woo Jong Shin, Dong-won Kim, Kyoung Hun Kim, Kyo Sang Kim
    Abstract:

    hemodynamic monitoring and for administration of hypertonic fluids, drugs, and parenteral nutrition. Common access sites are the internal Jugular veins, subclavian veins, and femoral veins. Yoffa's percutaneous supraclavicular subclavian vein catheterization technique has some disadvantages and difficulties which include dislodgement of the puncture needle and difficult enhancement of the guide Wire. To overcome these problems, we modified Yoffa's technique as a symmetrical puncture against the clavicle. Methods: A patient was placed supine with his/her head turned to the opposite side with the arm at the side. The needle was inserted through the skin at a point around 1 cm below the clavicle, toward the imaginary midline of the clavicular head of the sternocleidomastoid muscle (SCM). The guide Wire was inserted with a J-Wire. Measurements were made to determine the length from the puncture site to the lower border of the clavicle, the depth and angles from the needle to mid sagittal line, the coronary line and skin (Fig. 2). We also evaluated the No. of punctures, Wire insertions, and complications. Results: Our success rate was 95.1% and 6 cases with complications (5.9%) occurred in 102 attempts. The most serious complication was a delayed tension pneumothorax 6 h postoperatively. Conclusions: These results suggest that the new landmark for infraclavicular subclavian vein catheterization is an easy and safe procedure for an experienced physician. We also recommend close observation postoperatively for at least 24 h for complications.

David Bronheim - One of the best experts on this subject based on the ideXlab platform.

Ashraf Fayad - One of the best experts on this subject based on the ideXlab platform.

  • Confirmation of internal Jugular guide Wire position utilizing transesophageal echocardiography
    Canadian Journal of Anesthesia, 2001
    Co-Authors: Corey Sawchuk, Ashraf Fayad
    Abstract:

    Purpose To describe the utility of transesophageal echocardiography (TEE) in confirmation of correct central line J-Wire position. Clinical features A 51-yr-old male patient presented for urgent coronary artery bypass grafting. Current medications included aspirin, nitroglycerine, heparin and a B-blocker. Physical examination was unremarkable. Initial difficulty with right internal Jugular vein cannulation was encountered. A posterior approach was used to access the vein with further difficulty in passing the J-Wire. Simultaneous TEE images confirmed the correct J-Wire position. Conclusion The case demonstrates the value of TEE to confirm correct guide Wire position prior to insertion of a large bore central venous catheter. TEE visualization of J-Wire position avoided repeat attempts at internal Jugular cannulation and potential carotid artery puncture. ObJectif Décrire l’utilité de l’échocardiographie transœsophagienne (ETO) pour confirmer la position correcte d’un guide en J. Eléments cliniques Un homme de 51 ans s’est présenté pour un pontage aorto-coronarien d’urgence. Le patient était déJà traité avec de l’aspirine, de la nitroglycérine, de l’héparine et un B-bloquant. L’examen physique a été sans particularité. Dès la première tentative, la canulation de la veine Jugulaire interne droite s’est révélée difficile. Une approche postérieure a été utilisée pour accéder à la veine, mais le passage du guide en J a été aussi difficile. Les images de l’ETO simultanées ont confirmé la position correcte du guide en J. Conclusion Le présent cas démontre la valeur de l’ETO pour confirmer la position d’un guide métallique avant l’insertion d’un cathéter veineux central de grand calibre. La visualisation ETO de la position du guide en J évite la répétition des essais de canulation de la veine Jugulaire interne et la perforation possible de l’artère carotide.

  • Confirmation of internal Jugular guide Wire position utilizing transesophageal echocardiography.
    Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2001
    Co-Authors: Corey Sawchuk, Ashraf Fayad
    Abstract:

    Purpose To describe the utility of transesophageal echocardiography (TEE) in confirmation of correct central line J-Wire position.