Safe continuous ultrasonic guidance of venous punctures with a new finger-tip pulsed doppler probe

Abstract

Serious complications may occur after "blind" profound venous puncture in intensive care units. To securize these punctures, we designed a new fingertip pulsed doppler 4 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. This material was first tested in an experimental animal study. Results of animal venous punctures were successfull 20/21. This material was then tested on patients with previous failure of "blind" punctures: results of fingertip pulsed doppler guided (FPDG) punctures were successfull in all cases but one (catheterisation not completed). We started a prospective multi-unit randomized study with various operators (junior residents, senior staff members), compared the success rate, the complication rate and type, the procedure duration of blind standard verSUS FPDG punctures. We conclude in the safety and easy use of the FPDG central venous punctures.