Dataset Information

Ultrasound guidance versus anatomical landmarks for subclavian vein catheterization: a prospective study.

ABSTRACT:

Background

Several clinical practice guidelines strongly support the use of ultrasound guidance (USG) for internal jugular vein catheterization. The level of evidence concerning the use of USG for subclavian vein (SCV) cannulation remains low.

Aim

To compare the effectiveness and safety of USG and anatomical landmarks approaches for cannulation of SCV.

Methods

This was a prospective randomized study. Patients aged over 18 years old who requiring elective central venous catheterization were included. Non-inclusion criteria were thrombosis of the vein or major coagulopathy. All catheterizations were performed by two anaesthesiology residents. Patients were randomized into two groups: ultrasound guidance group (US group) and anatomical landmarks (LM group). The main outcome was the success rate. The secondary outcomes were the first attempt success rate and the incidence of complications.

Results

Seventy patients were included (35 in each group). The success rate was higher in US group compared to LM group without statistical significance (100% vs 85.7%; p=0.054). The first attempt success rate was significantly higher in the US group (82.9% vs. 40%; p <10^-3). The incidence of mechanical complications was significantly lower in the US group compared to LM group (5.7% vs. 37.1%; p=0,001).

Conclusion

according to our study, US guidance for SCV catheterization seems to be an interesting alternative to anatomical landmarks approaches.

SUBMITTER: Benali M

PROVIDER: S-EPMC9703904 | biostudies-literature | 2022 juillet

REPOSITORIES: biostudies-literature

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Publications

Ultrasound guidance versus anatomical landmarks for subclavian vein catheterization: a prospective study.

Benali Mechaal M Trabelsi Becem B Abdouli Hadhemi H Yedes Azza A Elhadj Kacem Hichem H Fki Mohamed M

La Tunisie medicale 20220101 7

<h4>Background</h4>Several clinical practice guidelines strongly support the use of ultrasound guidance (USG) for internal jugular vein catheterization. The level of evidence concerning the use of USG for subclavian vein (SCV) cannulation remains low.<h4>Aim</h4>To compare the effectiveness and safety of USG and anatomical landmarks approaches for cannulation of SCV.<h4>Methods</h4>This was a prospective randomized study. Patients aged over 18 years old who requiring elective central venous cath ...[more]

PMID: 36571740

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Project description:IntroductionCentral venous catheters are indispensable in modern healthcare. Unfortunately, they are accompanied by minor as well as major complications, leading to increased morbidity, mortality and costs. Immediate insertion-related complications (mechanical complications) have decreased due to the implementation of real-time ultrasound guidance, but they still occur and additional efforts to enhance patient safety are warranted. This study aims to investigate whether the use of a needle guide mounted on the ultrasound probe in subclavian catheterisations may decrease the number of catheterisations with >1 skin puncture (primary outcome).Methods and analysisThis is an investigator-initiated, non-commercial, randomised, controlled, parallel-group study conducted at Skåne University Hospital, Lund, Sweden. Adults (≥18 years) with a clinical indication for a subclavian central venous catheter and the ability to give written informed consent will be eligible for inclusion. Exclusion criteria include subclavian catheterisation deemed unsuitable based on the preprocedural ultrasound examination. Patients will be randomised to catheterisation by certified operators using a microconvex probe (long-axis, in-plane technique) with (n=150) or without (n=150) a needle guide. The ultrasound imaging from the procedures will be recorded and assessed by two reviewers individually. The assessors will be blinded for group affiliation. Secondary outcomes include the total number of skin punctures, mechanical complications, time to successful venous puncture, number of failed catheterisations and operator satisfaction with the needle guide at the end of the study period.Recruitment started on 8 November 2022 and will continue until the sample size is achieved.Ethics and disseminationThis study was approved by the Swedish Ethical Review Authority (#2022-04073-01) and the Swedish Medical Products Agency (#5.1-2022-52130; CIV-21-12-038367). The findings will be submitted to an international peer-reviewed journal.Trial registration numberNCT05513378, clinicaltrials.gov.

Dataset Information

Ultrasound guidance versus anatomical landmarks for subclavian vein catheterization: a prospective study.

Background

Aim

Methods

Results

Conclusion

Publications

Ultrasound guidance versus anatomical landmarks for subclavian vein catheterization: a prospective study.

Similar Datasets

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