The Effectiveness of Real-Time Ultrasound-Guided Central Venous Catheterization: A Comparison with the Landmark Technique in Jordanian Patients (original) (raw)
Related papers
PRILOZI, 2017
Introduction: Central venous catheterization is performed by the landmark method and ultrasound guided method. The purpose of the study was to compare the success, average number of attempts, average time to return of blood, and complication rate between the two methods. Material and Methods: This was a prospective study done in the Intensive Care Unit of the Acibadem Sistina Clinical Hospital, in Skopje. There were 400 patients in need of central venous catheter and they were prospectively randomized in two groups. The patients randomized in the examined-ultrasound group underwent real-time ultrasound-guided catheterization and the patients randomized in the control-landmark group were catheterized using the landmark method. Internal Jugular, Subclavian and Femoral vein were catheterized in both groups. The Overall success, success on the first attempt, time to the return of blood, number of attempts and complications at the moment of catheterization such as arterial puncture, pneu...
Objective: To determine the advantages of ultrasound guided central venous catheter insertion over anatomical land mark technique regarding ease of insertion and safety. Methodology: Sixty elective patients requiring central venous catheter were selected and randomly divided into two groups, e.g. ultrasound and anatomical landmark groups. Central catheter was inserted under aseptic measures by the same operator. Variables including ease of access, number of attempts, arterial punctures and other complications in both groups were recorded. Results: Ultrasound guidance in central catheter insertion resulted in a statistically significant ease of insertion (P = 0.024). while decreasing number of attempts to gain venous access as compared to the anatomical landmark group (p = 0.0453). Two cases of arterial puncture were recorded in the anatomical landmark group while no arterial puncture occurred in the ultrasound group. P <0.05 was considered significant. Conclusion: Ultrasonographic guidance for central catheter insertion makes it easy and safe as it allows better identification of vascular structures. It also reduces the rate of complications associated with central catheter insertion and improves the success rate thereby justifies its cost. Citation: Rehman A, Zeb H, Niazi AUK. Ultrasound guidance increases the safety and ease of insertion of central venous catheters in patients undergoing elective procedures. Anaesth Pain& Intensive Care 2015;19(4):474-477
The journal of vascular access, 2017
Centrally inserted central catheter (CICC) insertion is a commonly performed procedure that may give rise to different complications. Despite the suggestion of guidelines to use ultrasound guidance (USG) for vascular access, not all centers use it systematically. The aim of this study is to illustrate the experience with ultrasound in CICC placement at a high-volume oncological center, in a country where the landmark technique is standard. Retrospective analysis of a prospective database was performed on CICC placement under USG in the Central Venous Catheter Unit of Instituto Português de Oncologia de Lisboa Francisco Gentil, from 2012 to 2015. Three thousand five hundred and seventy-two procedures were recorded. From 2728 CICC placements, 1187 (43.5%) were done using USG. The majority of CICC placements were successful without immediate complications (96.1%). In 55 cases (4.6%), more than three attempts were necessary to puncture the vein. Pneumothorax occurred in 5 cases (0.4%) a...
Ultrasound-Guided Central Venous Catheterization: A Protocol to Be Followed in Pediatrics?
Open Journal of Pediatrics, 2017
Objective: To investigate the effectiveness of ultrasound-guided central venous catheterization when compared to the conventional procedure. Method: A prospective cohort study was carried out over a 9-month period from February to October 2016 involving 144 inpatients at PICU of Irmandade da Santa Casa de São Paulo Hospital, undergoing central venous catheterization. The patients were matched in pairs of identical patients according to the levels of potentially intervening variables (age, nutritional status, puncture site, professional experience), differing only as to the CVC technique: ultrasound-guided (USG-CVC) or conventional (C-CVC). Discarding data from non-paired patients, the remaining did forming 47 pairs, matched as two related samples: USG-CVC and C-CVC groups. Success parameters: number of puncture attempts; time spent at CVC; success rate and complications. Results: In the USG-CVC group, the number of attempts (mean = 2.04) and the time spent at catheterization (mean = 11.89 minutes) were lower (t = 2.34, df = 46, t 0.95 = 2.02, p < 0.05) and (t = 3.07, df = 46, t 0.95 = 2.02, p < 0.05), respectively, when compared to the results obtained for the control group (C-GVC), (mean = 3.21) and (mean = 28.26 minutes), respectively. As to success, there was observed a significant difference (F (1, 46) = 16.6; Q (1) = 12.5, p < 005) when considering only one trial (USG-CVC = 27/47; C-CVC = 9/47), but no significant difference (F (1, 46) = 3.76; Q (1) = 3.56, p > 0.05) when considering several attempts. Complications were found less frequently in the USG-CVC group (3/47) than in the CVC-C (13/47), (F (1, 46) = 8.24; Q (1) = 7.14, p < 0.05). Conclusion: USG-CVC was found to be more effective than the conventional technique, especially regarding success at the first puncture attempt.
International Journal of Medical Research & Health Sciences, 2020
Background: Central Venous Catheter (CVC) is an interventional procedure used during anesthesia and critical care for the administration of drugs, fluids and to measure blood pressure as well as other medical uses. There are two methods for the insertion of a Central Venous Catheter, ultrasound imaging, and anatomical landmarks. The CVC is inserted into a central vein such as the internal jugular, Subclavian, and femoral veins in sterile procedures with as few attempts as possible to reduce complications. Objective: The study aimed to review the incidence of complications during the insertion of central venous catheterization guided by ultrasound versus an anatomical landmark. Methodology: The researchers collected papers that met the criteria and were already published in databases, i.e., the Wiley digital library, Scopus, PubMed, Google Scholar, and Cochrane Databases in the period of (2000-2020). The sample consisted of 25 articles. Mesh headings searched included ultrasound, anatomical landmark, central venous cannulation, and complications. Result: Findings of 24 (96%) Randomized Controlled Trials (RCT) in different parts of the world revealed that the ultrasound imaging method has fewer complications than anatomical landmark during central venous cannulation, A p-value<0.05, and only 1(4%) study showed the insignificance with the p-value is >0.05. Conclusion: According to all previous studies, the review concluded that ultrasound imaging is more effective in reducing complications compared to the anatomical landmark technique in patients requiring central venous catheter insertion. And this review is recommending further studies to discover other factors that can reduce the complications.
The Journal of Vascular Access
Purpose: Central venous catheter insertion is a common procedure in the intensive care setting. However, complications persist despite real-time ultrasound guidance. Recent innovation in needle navigation technology using guided positioning system enables the clinician to visualize the needle’s real-time position and trajectory as it approaches the target. We hypothesized that the guided positioning system would improve performance time in central venous catheter insertion. Methods: A prospective randomized study was conducted in a single-center adult intensive care unit. In total, 100 patients were randomized into two groups. These patients underwent internal jugular vein central venous catheter cannulation with ultrasound guidance (short-axis scan, out-of-plane needling approach) in which one group adopted conventional method, while the other group was aided with the guided positioning system. Outcomes were measured by procedural efficacy (success rate, number of attempts, time to...
Macedonian Medical Review, 2017
Introduction. Central venous catheterization of the subclavian vein can be achieved with a landmark and an ultrasound-guided method. Using ultrasound the vein can be catheterized with a long axis in plane or a short axis out of plane approach and a combined approach. The aim of the study was to compare the success, average number of attempts and mechanical complication rate between the landmark and the combined ultrasound-guided method. Methods. A total of 162 adult patients from the Intensive Care Unit at Clinical Hospital Acibadem-Sistina, Skopje were included in this prospective study. Patients randomized in the examined group (n=71) were catheterized with real-time ultrasound guidance with a combined short axis out of plane and long axis in plane method. Patients randomized in the control group (n=91) were catheterized with the landmark method. Subclavian vein was catheterized in both groups. Overall success, success on first attempt, number of attempts and complications at the ...
Harran Üniversitesi Tıp Fakültesi Dergisi
Background: To compare the rates of success and the complications that can develop during the central venous catheterizations with ultrasonography and Landmark methods, usually used in the intensive care unit. Methods: This study was conducted retrospectively by scanning the files of 100 patients. Patients were divided into two groups as Ultrasonography (n=49) and Landmark (n=51). The distribution of the catheter diameters with the information obtained from the files based on groups, from which artery the operation was made based on the groups, the distribution of gender based on the groups, and the complications that occurred were compared. Results: In our study, the distribution of the thickness of the catheters used for CVCs did not vary by group, there was no variation in terms of gender distribution in the groups, the CVC was not entered with the USG method, 1 multiple-operation was tried in the IJV catheterization with the USG method, and no other complications were experienced. Conclusions: USG method is a reliable, practical, and applicable method in ICU for CVC (excepted SCV(subclavian vein)) application.
Is Long-Axis View Superior to Short-Axis View in Ultrasound-Guided Central Venous Catheterization?*
Critical Care Medicine, 2015
Objective: To evaluate whether using long-axis or short-axis view during ultrasound-guided internal jugular and subclavian central venous catheterization results in fewer skin breaks, decreased time to cannulation, and fewer posterior wall penetrations. Design: Prospective, randomized crossover study. Setting: Urban emergency department with approximate annual census of 60,000. Subjects: Emergency medicine resident physicians at the Denver Health Residency in Emergency Medicine, a postgraduate year 1-4 training program. Interventions: Resident physicians blinded to the study hypothesis used ultrasound guidance to cannulate the internal jugular and subclavian of a human torso mannequin using the long-axis and short-axis views at each site. Measurements and Main Results: An ultrasound fellow recorded skin breaks, redirections, and time to cannulation. An experienced ultrasound fellow or attending used a convex 8-4 MHz transducer during cannulation to monitor the needle path and determine posterior wall penetration. Generalized linear mixed models with a random subject effect were used to compare time to cannulation, number of skin breaks and redirections, and posterior wall penetration of the long axis and short axis at each cannulation site. Twenty-eight resident physicians participated: eight postgraduate year 1, eight postgraduate year 2, five postgraduate year 3, and seven postgraduate year 4. The median (interquartile range) number of total internal jugular central venous catheters placed was 27 (interquartile range, 9-42) and subclavian was six catheters (interquartile range, 2-20). The median number of previous ultrasound-guided internal jugular catheters was 25 (interquartile range, 9-40), and ultrasound-guided subclavian catheters were three (interquartile range, 0-5). The long-axis view was associated with a significant decrease in the number of redirections at the internal jugular and subclavian sites, relative risk 0.4 (95% CI, 0.2-0.9) and relative risk 0.5 (95% CI, 0.3-0.7), respectively. There was no significant difference in the number of skin breaks between the long axis and short axis at the subclavian and internal jugular sites. The long-axis view for subclavian was associated with decreased time to cannulation; there was no significant difference in time between the short-axis and long-axis views at the internal jugular site. The prevalence of posterior wall penetration was internal jugular short axis 25%, internal jugular long axis 21%, subclavian short axis 64%, and subclavian long axis 39%. The odds of posterior wall penetration were significantly less in the subclavian long axis (odds ratio, 0.3; 95% CI, 0.1-0.9).