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Randomized Controlled Trial
Guidewire-Assisted Nasogastric Tube Insertion in Intubated Patients in an Emergency Center
Jin Go, Hyunjong Kim, Seunghwan Kim, Je Sung You, Min Joung Kim, Hyun Soo Chung, Sung Phil Chung, Hahn Shick Lee
Korean J Crit Care Med. 2013;28(4):287-292.
DOI: https://doi.org/10.4266/kjccm.2013.28.4.287
  • 3,232 View
  • 51 Download
AbstractAbstract PDF
BACKGROUND
The purpose of this study is to identify the usefulness of guidewire-assisted nasogastric tube insertion in intubated patients with cervical spine immobilization or unstable vital signs in an emergency center.
METHODS
Thirty-four intubated patients in an emergency center were enrolled in the study. Patients were randomly allocated to the control group or the guidewire group. All patient necks were kept in neutral position during the procedure. In the control group, the nasogastric tube was inserted with the conventional method. A guidewire-supporting nasogastric tube was used in the guidewire group. The success rates of the first attempts and overall were recorded along with complications.
RESULTS
The first attempt success rate was 88.2% in the guidewire group compared with 35.2% in the control group (p < 0.001). The overall success rate was 94.2% in the guidewire group and 52.9% in the control group (p = 0.017). Five cases of self-limiting nasal bleeding were reported in the guidewire group, and two cases occurred in the control group. No statistical differences were identified between groups.
CONCLUSIONS
Guidewire-assisted nasogastric tube insertion is a simple and useful method in intubated patients with cervical spine immobilization or unstable vital signs.
Case Reports
Knotting and Kinking of the Guidewire during Central Venous Catheterization: A Case Report
Deokkyu Kim, Ji Hye Lee, Dong Chan Kim, Hyungsun Lim, Seonghoon Ko, Ji Seon Son
Korean J Crit Care Med. 2011;26(1):38-40.
DOI: https://doi.org/10.4266/kjccm.2011.26.1.38
  • 2,764 View
  • 30 Download
AbstractAbstract PDF
Central venous catheterization is often necessary to manage critically ill patients in the intensive care unit and some surgical patients in the operating room. However, this procedure can lead to various complications. We experienced a case of subclavian venous catheterization that was complicated by looping, kinking, knotting, and entrapment of the guidewire. We were able to identify the extravascular looping and knotting of the guidewire under fluoroscopy and consequently removed it successfully. We suggest that a guidewire should be confirmed by fluoroscopic imaging if it has become entrapped.
Intracardiac Knotting of a Balloon-tipped, Flow-directed Pulmonary Artery Catheter: A Case Report
Bong Chul Choi, Mee Young Chung, Chang Jae Kim, Jun Seuk Chea, Byung Ho Lee
Korean J Crit Care Med. 2005;20(2):178-182.
  • 1,776 View
  • 14 Download
AbstractAbstract PDF
The occurrence of knots and loops is a potential hazard of a balloon-tipped, flow-directed pulmonary artery (PA) catheter placement if excessive catheter length is passed into the right atrium or ventricle. Knotting of a balloon-tipped, flow-directed PA catheter leading to difficulty in its removal is a rare but serious complication. A case of knotted catheter in right atrium in a patient undergoing aortic valve replacement is presented. By passing a spring guidewire into PA catheter, we have untied the loose knotted catheter under simple fluoroscopic guidance in the intensive care unit.

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