新型イントロデューサー（Ａｄｖａｎｃｅｄ　Ｖｅｎｏｕｓ　Ａｃｃｅｓｓ：ＡＶＡ）の有用性の検討

• Published in: 蘇生 Vol. 22; no. 2; pp. 106 - 110
• Main Authors: Takeyama Kazuhide, Suzuki Toshiyasu
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Reanimatology 2003; 日本蘇生学会
• Subjects: Advanced Venous Access; high flow rate; PAC; 高流量
• ISSN: 0288-4348; 1884-748X
• DOI: 10.11414/jjreanimatology1983.22.106

Advanced Venous Access (AVA) is a catheter that can be used as sheath intro-ducer for inserting a pulmonary artery catheter (PAC) and also as a central venous catheter that enables high flow fluid infusion and/or blood transfusion.The flow characteristics of the AVA were investigated in this study.The blood transfusion circuit was set so that the surface of the drip tube would be at 130 cm.An AVA or an 8-Fr sheath introducer was connected alternately to the peripheral end of the circuit.The minute flow rates of LRS, HES, and PRBC were measured before and after introducing a PAC.The flow rate of LRS decreased markedly from 120 mL/min to 5 mL/min after introducing PAC for the 8-Fr sheath introducer.When the AVA was used, the flow rate of LRS decreased slightly after PAC introduction.The flow rate of LRS after PAC insertion was equivalent to that of 2 or 3 16-G venous catheters.The results suggest that the AVA is a useful device because hemodynamic monitoring and high volume infusion/transfusion can be performed simultaneously. 【目的】Advanced Venous Access (以下AVA) は, 肺動脈カテーテル (以下PAC) の挿入が行なえて, かつ大量輸液が可能なカテーテルとされる。この流量特性をPAC挿入前後で比較した。【方法】輸液回路を組み立て, AVAと8Fシースイントロデューサーに接続してPAC挿入前後での乳酸加リンゲル液 (Lactec Ringer Solution: 以下LRS) , ヒドロキシエチルスターチ (Hydroxyethylated starch: 以下HES) , 赤血球濃厚液 (Mannitol-Adenine-Phosphate: 以下MAP) の1分間流量を測定した。【結果】AVAのPAC挿入下の流量は挿入前に比べて有意に減少したが, その量は16G静脈留置針約2本分以上を保った。一方8FシースイントロデューサーのPAC挿入下の流量は挿入前に比べて激減した。【結語】AVAは優れた特性をもつカテーテルと思われた。