Applied observation of Ambesh maneuver combined with wire pull action during subclavian vein catheterization

Objective:To evaluate the manual occlusion of the internal jugular vein(Ambesh maneuver) combined with wire pull action during subclavian vein catheterization(SVC) for preventing misplacement of the catheters into ipsilateral internal jugular vein(IJV) . Method:A study was made based on 274 patients undergone SVC through Ambesh maneuver between November 2009 and October 2010,and 227 patients undergone routine maneuver between November 2008 and October 2009 as control group,which the incidence of correct placement and misplacement of the catheters into the ipsilateral IJV had been accounted respectively compared. Result:The rate of the incidence of ipsilateral correct placement of the catheters into the IJV was 95.99% in the experiment group and that in control group was 90.75%,while significance was confirmed by chi-square test(P0.05) . The rate of the incidence of misplacement of the catheters into the IJV in the experiment group was 1.46% and that in control group was 7.05%,and the rate in the experiment group was significantly lower than in control group(P0.05) . In the experiment groups,the rate of the incidence of ipsilateral correct placement of the catheters into the IJV in the conscious group was 97.18% and that in the unconcious group was 91.8%,while no significance was confirmed by chi-square test between them(P0.05) . The rate of the incidence of misplacement of the catheters into the IJV in the concious group was 0.47% and that in the unconcious group was 4.92%,while significance was confirmed by Fisher's Exact test(P0.05) . Conclusion:Ambesh maneuver combined with wire pull action can effectively reduce the incidence of ipsilateral misplacement of the catheters into the IJV during SVC.