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J Korean Soc Emerg Med > Volume 28(4); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(4): 345-353.
대퇴 중심정맥관 삽입을 위한 표면해부학적 위치와 대퇴 동맥 정맥의 관계 확인: 초음파를 이용한 전향적 연구
박연순1, 김혜정1, 조영순1*, 이보라2, 이경민1, 신희준1, 김호중1, 김기운1, 임훈1
1순천향대학교 부천병원 응급의학과
2순천향대학교 부천병원 임상시험센터 의학통계상담실
Confirmation of the Relation between Femoral Artery and Vein for Central Venous Cannulation: A Prospective Investigation Using Ultrasound
Yeon Soon Park1, Hae Jung Kim1, Young Soon Cho1*, Bora Lee2, Kyung Min Lee1, Hee Jun Shin1, Ho Jung Kim1, Gi Woon Kim1, Hoon Lim1
1Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
2Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
Correspondence  Young Soon Cho ,Tel: 032-621-6369, Fax: 032-327-3549, Email: emer0717@gmail.com,
Received: March 21, 2017; Revised: March 22, 2017   Accepted: June 9, 2017.  Published online: August 31, 2017.
ABSTRACT
Purpose:
Femoral vein catheterization is often performed using a landmark technique, despite the recommended method of using ultrasound guidance. Although the landmark-based procedure is a well-known, widely adopted method to date, there are insufficient studies validating the effectiveness of this method. Hence, the purpose of this study was to confirm the relationship between femoral artery and vein using an ultrasound, as well as to validate the effectiveness of the femoral vein catheterization method using the landmark technique.
Method:
This was a prospective, repeated measurement study. Using an ultrasound with a 10 MHz transducer, the femoral vein cross-sectional areas on the right side were saved at a distance of 1, 2, 3, and 4 cm from the inguinal ligament with supine and hip abduction-external rotation positions. The width of the femoral vessels, center-to-center distance between the femoral artery and vein(horizontal distance between the center of the femoral artery and vein) and width of exposed femoral vein (not posterior to femoral artery) were measured.
Results:
The width of the femoral vein, the center-to-center distance between the femoral artery and vein, as well as the width of the exposed femoral vein were significantly decreased as the distance from the inguinal ligament was increased, regardless of the posture change (p<0.001). However, at a distance of 1 cm from the inguinal ligament, only 5.4% of the femoral veins were exposed without disturbance of the femoral artery, and there were also a few cases in which the femoral veins were not exposed at all.
Conclusion:
It appears that an ultrasound-guided femoral vein catheterization is recommended over the conventional landmark technique.
Key words: Catheterization, central venous, Femoral vein, Anatomic landmarks, Ultrasonography
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