SESSION TYPE: Invasive Procedures and Hemodynamic Monitoring Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: The Compass Vascular Access Device (Mirador Biomedical, Seattle,WA) is a disposable pressure transducer, inserted between the needle and syringe, that measures real-time systolic pressure during insertion of a central venous catheter (CVC), thus decreasing the risk of arterial cannulation. An integrated port allows guidewire insertion with pressure guidance. This device may be beneficial in ensuring safe CVC insertion.
METHODS: We tested the device in 25 patients requiring placement of a CVC. The Compass was used in 22 internal jugular and 2 femoral vein catheter insertions. CVC’s were inserted using real-time ultrasound guidance under strict aseptic conditions using the Seldinger technique. Each venous cannulation was confirmed with guidewire visualization and manometry which is our standard of care. The operator then completed a written survey.
RESULTS: The Compass Vascular Access Device was tested successfully 22 of 24 patients. One device was not used due to battery failure. In 2 patients, the device impeded proper utilization of ultrasound during needle cannulation and was not used. The average venous pressure was 6.36±5.67 mmHg. No arterial punctures occurred. Four accurate venous cannulations were unattainable during wire insertion through the device because of inadvertent movement of the needle out of the vein. The operator survey revealed that the Compass was an effective and accurate additional tool to ensure safe insertion of a CVC.
CONCLUSIONS: The Mirador Compass Vascular Access Device was tested in an elective setting, and through our experience, we discovered that the device accurately and efficiently identifies venous punctures. Despite minor limitations, the device adds to the current modalities of guidewire visualization and manometry in confirming accurate venous cannulation prior to dilation and central venous catheter insertion.
CLINICAL IMPLICATIONS: The Compass Vascular Access Device may be a useful tool to prevent inadvertent arterial placement of a CVC.
DISCLOSURE: The following authors have nothing to disclose: Nirav Mistry, Anthony Manasia, Andrew Leibowitz
No Product/Research Disclosure InformationMount Sinai Hospital, New York, NY