Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC
American Journal of Nursing Science
Volume 9, Issue 4, August 2020, Pages: 244-248
Received: Jun. 6, 2020;
Accepted: Jun. 20, 2020;
Published: Jun. 28, 2020
Views 147 Downloads 54
Ying Wu Qiufeng Li, The First Affiliated Hospital of Jinan University, Guangzhou, China
Jinai He, The First Affiliated Hospital of Jinan University, Guangzhou, China
Mengying Qi, The First Affiliated Hospital of Jinan University, Guangzhou, China
Shanquan Li, Shenzhen Hospital of Cancer Hospital, Chinese Academy of Medical Sciences, Shenzhen, China
Yutong Li, The First Affiliated Hospital of Jinan University, Guangzhou, China
Guohua Huang, The First Affiliated Hospital of Jinan University, Guangzhou, China
Zuyan Fan, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Qiufeng Li, The First Affiliated Hospital of Jinan University, Guangzhou, China
Follow on us
Purpose: To investigate the causes and the nursing interventions of vasovagal syncope (VVS) during ultrasound-guided Modified Seldinger Technique (MST) PICC catheterization. Methods: Clinical data (medical records, demographic data, diagnosis, local vascular compression situation, B-mode ultrasound-recorded catheter/vessel ratio and the occurrence time, symptoms and treatment of syncope) of 14 patients diagnosed as vasovagal syncope during ultrasound-guided PICC catheterization at three hospitals in Guangdong province from September 2018 to September 2019 were collected for this retrospective analysis. Results: There were 3091 cases of ultrasound-guided MST PICC catheterization in the venous catheter outpatient clinics of the 3 hospitals from September 2018 to October 2019 with 14 cases (0.45%) of intraoperative vasovagal syncope, all cancer patients (5 males, 9 females) with a mean age 45± 3.8. They all received PICC for the first time and were under mental stress during the operation. Among the 14 patients (2 mild, 7 moderate, 5 severe), 8 had multiple lymphadenectasis in the neck and clavicular areas of the catheterization side, which resulted in different degree of venous compression and difficulty in insertion; 5 had catheter/vessel ratio over 45%. 2 cases of VVS occurred when the patients were asked to turn their heads against shoulders on to the puncture side; 10 occurred when using B-mode ultrasound probe to examine the jugular vein; 2 occurred when pulling out the catheter sheath. Conclusion: The related factors of vasovagal syncope during ultrasound-guided PICC catheterization include overcompression and avulsion on blood vessels and mental stress. Therefore, it is recommended to implement psychological interventions before surgery, reduce compression and avulsion of the vascular access during catheterization, and improve practitioners’ abilities in vessel selection (vessels with a catheter/vessel ratio less than 45%) and catheterization skills to eliminate the incidence of vasovagal syncope during PICC catheterization.
Ultrasound Guidance, Peripherally Inserted Central Catheter, Vasovaga Syncope, Cancer Patients, Cause, Nursing Interventions
To cite this article
Ying Wu Qiufeng Li,
Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC, American Journal of Nursing Science.
Vol. 9, No. 4,
2020, pp. 244-248.
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Johansson E, Hammarskjöld F, Lundberg D, et al. Advantages and disadvantages of inserted central venous catheters (PICC) compared to other central venous lines: a systematic review of the literature [J]. Acta oncologica, 2013, 52 (5): 886-892.
Hunter M. Peripherally inserted central catheter placement: the speed of sound [J]. Nutrition in Clinical Practice, 2007, 22 (4): 406-411.
SLOAN H E. The vagus nerve in cardiac arrest; the effect of hypercapnia, hypoxia and asphyxia on reflex inhibition of the heart [J]. Surgery, gynecology & obstetrics, 1950, 91 (3): 257-264.
Alboni P. The different clinical presentations of vasovagal syncope. Heart, 2015, 101 (9): 674-8.
Brignole M, Moya A, de Lange FJ, Deharo JC, Elliott PM, Fanciulli A, Fedorowski A, FurlanR, Kenny RA, Martin A, Probst V, Reed MJ, Rice CP, Sutton R, Ungar A, van Dijk JG; ESC Scientific Document Group. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018; 39 (21): 1883-1948.
Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, Olshansky B, Raj SR, Sandhu RK, Sorajja D, Sun BC, Yancy CW. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: Executive Summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017; 136 (5): e25-e59.
Humm AM, Z'Graggen WJ. Venepuncture during head-up tilt testing in patients with suspected vasovagal syncope – implications for the test protocol [J]. Eur J Neurol, 2015; 22 (2): 389-94.
Olshansky B. Vagus nerve modulation of inflflammation: Cardiovascular implications [J]. Trends Cardiovasc Med, 2016, 26 (1): 1-11.
Thrasher TN. Baroreceptors, baroreceptor unloading, and the long-term control of blood pressure [J]. Am J Physiol Regul Integr Comp Physiol. 2005; 288 (4): R819- R827.
Huston J M, Fritz J R. The inflammatory reflex and neural tourniquet: harnessing the healing power of the vagus nerve [J]. 2018, 1 (1): 29-38.
Inoue T, Abe C, Sung SS, Moscalu S, Jankowski J, Huang L, Ye H, Rosin DL, Guyenet PG, Okusa MD. Vagus nerve stimulation mediates protection from kidney ischemia-reperfusion injury through α7nAChR+ splenocytes [J]. J Clin Invest, 2016, 126 (5): 1939-52.
Kohno R, Detloff BLS, Chen LY, Norby FL, Benditt DG. Greater early epinephrine rise with head-up posture: A marker of increased syncope susceptibility in vasovagal fainters [J]. J Cardiovasc Electrophysiol, 2019, 30 (3): 289-296.
The 2016 Infusion Therapy Standards of Practice [J]. Home Healthcare Now, 2017, 35 (1): E1-E2. DOI: 10.1097/NHH.0000000000000504.