Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC

Ying Wu; Jinai He; Mengying Qi; Shanquan Li; Yutong Li; Guohua Huang; Zuyan Fan; Qiufeng Li

doi:doi:10.11648/j.ajns.20200904.23

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Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC

Ying Wu, Jinai He, Mengying Qi, Shanquan Li, Yutong Li, Guohua Huang, Zuyan Fan, Qiufeng Li

Published in American Journal of Nursing Science (Volume 9, Issue 4)

Received: 6 June 2020 Accepted: 20 June 2020 Published: 28 June 2020

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Abstract

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.

Published in	American Journal of Nursing Science (Volume 9, Issue 4)
DOI	10.11648/j.ajns.20200904.23
Page(s)	239-243
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Ultrasound Guidance, Peripherally Inserted Central Catheter, Vasovaga Syncope, Cancer Patients, Cause, Nursing Interventions

References

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[2]	Hunter M. Peripherally inserted central catheter placement: the speed of sound [J]. Nutrition in Clinical Practice, 2007, 22 (4): 406-411.
[3]	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.
[4]	Alboni P. The different clinical presentations of vasovagal syncope. Heart, 2015, 101 (9): 674-8.
[5]	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.
[6]	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.
[7]	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.
[8]	Olshansky B. Vagus nerve modulation of inflflammation: Cardiovascular implications [J]. Trends Cardiovasc Med, 2016, 26 (1): 1-11.
[9]	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.
[10]	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.
[11]	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.
[12]	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.
[13]	The 2016 Infusion Therapy Standards of Practice [J]. Home Healthcare Now, 2017, 35 (1): E1-E2. DOI: 10.1097/NHH.0000000000000504.

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APA Style

Ying Wu, Jinai He, Mengying Qi, Shanquan Li, Yutong Li, et al. (2020). Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC. American Journal of Nursing Science, 9(4), 239-243. https://doi.org/10.11648/j.ajns.20200904.23

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ACS Style

Ying Wu; Jinai He; Mengying Qi; Shanquan Li; Yutong Li, et al. Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC. Am. J. Nurs. Sci. 2020, 9(4), 239-243. doi: 10.11648/j.ajns.20200904.23

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AMA Style

Ying Wu, Jinai He, Mengying Qi, Shanquan Li, Yutong Li, et al. Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC. Am J Nurs Sci. 2020;9(4):239-243. doi: 10.11648/j.ajns.20200904.23

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@article{10.11648/j.ajns.20200904.23,
  author = {Ying Wu and Jinai He and Mengying Qi and Shanquan Li and Yutong Li and Guohua Huang and Zuyan Fan and Qiufeng Li},
  title = {Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC},
  journal = {American Journal of Nursing Science},
  volume = {9},
  number = {4},
  pages = {239-243},
  doi = {10.11648/j.ajns.20200904.23},
  url = {https://doi.org/10.11648/j.ajns.20200904.23},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20200904.23},
  abstract = {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.},
 year = {2020}
}

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TY  - JOUR
T1  - Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC
AU  - Ying Wu
AU  - Jinai He
AU  - Mengying Qi
AU  - Shanquan Li
AU  - Yutong Li
AU  - Guohua Huang
AU  - Zuyan Fan
AU  - Qiufeng Li
Y1  - 2020/06/28
PY  - 2020
N1  - https://doi.org/10.11648/j.ajns.20200904.23
DO  - 10.11648/j.ajns.20200904.23
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 239
EP  - 243
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20200904.23
AB  - 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.
VL  - 9
IS  - 4
ER  -

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Author Information

Ying Wu

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

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Plain Text BibTeX RIS

APA Style

Ying Wu, Jinai He, Mengying Qi, Shanquan Li, Yutong Li, et al. (2020). Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC. American Journal of Nursing Science, 9(4), 239-243. https://doi.org/10.11648/j.ajns.20200904.23

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ACS Style

Ying Wu; Jinai He; Mengying Qi; Shanquan Li; Yutong Li, et al. Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC. Am. J. Nurs. Sci. 2020, 9(4), 239-243. doi: 10.11648/j.ajns.20200904.23

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AMA Style

Ying Wu, Jinai He, Mengying Qi, Shanquan Li, Yutong Li, et al. Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC. Am J Nurs Sci. 2020;9(4):239-243. doi: 10.11648/j.ajns.20200904.23

Copy | Download

@article{10.11648/j.ajns.20200904.23,
  author = {Ying Wu and Jinai He and Mengying Qi and Shanquan Li and Yutong Li and Guohua Huang and Zuyan Fan and Qiufeng Li},
  title = {Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC},
  journal = {American Journal of Nursing Science},
  volume = {9},
  number = {4},
  pages = {239-243},
  doi = {10.11648/j.ajns.20200904.23},
  url = {https://doi.org/10.11648/j.ajns.20200904.23},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20200904.23},
  abstract = {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.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Analysis on Related Factors and Nursing Interventions of Vasovagal Syncope During Ultrasound-guided PICC
AU  - Ying Wu
AU  - Jinai He
AU  - Mengying Qi
AU  - Shanquan Li
AU  - Yutong Li
AU  - Guohua Huang
AU  - Zuyan Fan
AU  - Qiufeng Li
Y1  - 2020/06/28
PY  - 2020
N1  - https://doi.org/10.11648/j.ajns.20200904.23
DO  - 10.11648/j.ajns.20200904.23
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 239
EP  - 243
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20200904.23
AB  - 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.
VL  - 9
IS  - 4
ER  -

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