A novel technique for ultrasound-guided central venous catheterization under short-axis out-of-plane approach: “stepwise flashing with triangulation”

2017 ◽  
Vol 31 (5) ◽  
pp. 789-793
Author(s):  
Toshinori Horiuchi ◽  
Chie Okuda ◽  
Naoko Kurita ◽  
Ayako Yamaguchi ◽  
Kazuhiko Kitagawa ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Novel Technique ◽  
Venous Catheterization ◽  
Out Of Plane

Landmark Versus Ultrasound-Guided Subclavian Central Venous Catheterization with a Combined Short and Long Axis Approach in an Intensive Care Setting

2017 ◽  
Vol 71 (1) ◽  
pp. 44-49
Author(s):  
Darko Sazdov ◽  
Marija Jovanovski Srceva ◽  
Zorka Nikolova Todorova
Keyword(s):  
Intensive Care ◽  
Real Time ◽  
Complication Rate ◽  
Ultrasound Guidance ◽  
Central Venous Catheterization ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Venous Catheterization ◽  
Out Of Plane

Abstract 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 moment of catheterization were the main outcome measures. Results. Catheterization using the landmark method was successful in 94.5% of patients, 65.9% of which during the first attempt. Cannulation using real-time ultrasound guidance was successful in all patients with a first pas success of 83.1%. The complication rate in the ultrasound group was 2.82% and 16.5% in the landmark group (p=0.004404). Conclusion. Real-time ultrasound guidance with a combined short axis out of plane and long axis in plane approach improves success, decreases number of attempts, and reduces mechanical complications rate.

scholarly journals Is Long-Axis View Superior to Short-Axis View in Ultrasound-Guided Central Venous Catheterization?*

2015 ◽  
Vol 43 (4) ◽  
pp. 832-839 ◽  
Author(s):  
Jody A. Vogel ◽  
Jason S. Haukoos ◽  
Catherine L. Erickson ◽  
Michael M. Liao ◽  
Jonathan Theoret ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Short Axis ◽  
Short Axis View ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Venous Catheterization ◽  
Axis View

Oblique-axis vs. Short-axis View in Ultrasound-guided Central Venous Catheterization

2014 ◽  
Vol 47 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Jennifer G. Wilson ◽  
Kristin M. Berona ◽  
John C. Stein ◽  
Ralph Wang
Keyword(s):  
Central Venous Catheterization ◽  
Short Axis ◽  
Short Axis View ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Venous Catheterization ◽  
Axis View

scholarly journals A Shallow Angle Short-Axis Out-of-Plane Approach Reduces the Rate of Posterior Wall Injuries in Central Venous Catheterization: A Simulation Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Kunitaro Watanabe ◽  
Joho Tokumine ◽  
Alan Kawarai Lefor ◽  
Akira Motoyasu ◽  
Kumi Moriyama ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Clinical Training ◽  
Central Venous Catheterization ◽  
Posterior Wall ◽  
Guidance System ◽  
Short Axis ◽  
Central Venous ◽  
Vein Wall ◽  
Venous Catheterization ◽  
Out Of Plane

The short-axis out-of-plane approach (SAX-OOP) is commonly used in ultrasound-guided internal jugular vein catheterization. However, this approach has a risk of posterior vein wall injuries. The authors hypothesized that a shallow angle of approach may reduce the rate of posterior wall injuries compared with the conventional steep angle approach. The present study aimed to evaluate whether a difference in the angle of approach of the needle affects the rate of posterior wall injuries. The present study was a randomized crossover-controlled trial involving 40 medical residents, conducted in the clinical training center at a hospital with a residency program. The primary outcome measure was the rate of posterior vessel wall injuries. Subjects received a didactic lecture during which the instructors taught three SAX-OOP techniques including the conventional free-hand method (procedure C), a needle navigation system (procedure N), and a shallow puncture angle using a guidance system (procedure S). Participants were trained in these approaches under supervision and each technique tested in a simulation environment. Thirty-four of 40 residents had no previous experience with central venous catheterization and were included in the final analysis. The rate of posterior vessel wall injuries in procedure S (9%) was significantly lower than using the other approaches (procedure C, 53%; procedure N, 41%). In conclusion, a shallow angle of approach using the SAX-OOP technique resulted in significantly fewer posterior vein wall injuries in central venous catheterization compared with steep angle techniques.

scholarly journals Ultrasound guided versus land mark technique for internal jugular central venous catheterization in cardiac surgical patients- a randomized trial

2016 ◽  
Vol 3 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Santosh Sharma Parajuli ◽  
Jeju Nath Pokharel
Keyword(s):  
Internal Jugular Vein ◽  
Central Venous Catheterization ◽  
Jugular Vein ◽  
Venous Cannulation ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Successful Cannulation ◽  
Venous Catheterization ◽  
Complications Rate ◽  
Landmark Technique

Background: Catheterization of internal jugular vein can be achieved by either anatomical landmark technique or the ultrasound guided technique. The objective of our study is to find out if ultrasound guided technique could be beneficial in placing central venous catheters by improving the success rate by reducing the number of attempts, decreasing the access time and decreasing the complications rate in comparison to the landmark technique.Methods: Fifty patients scheduled for cardiac surgery requiring central venous cannulation of the right internal jugular vein were divided into two groups: ultrasound guided group ‘U’ and the landmark group ‘L’, each consisting of 25 patients with age more than 15 years. The outcomes were compared in terms of success rate, time taken for successful cannulation and rate of complications.Results: The two groups were comparable in terms of age, weight, heart rate and blood pressure. The mean number of attempts for successful cannulation was 1.08±0.277 and 1.40±0.764 (p=0.055), the time taken in seconds for successful cannulation was 108.56±27.822 and 132.08±72.529 (p=0.137) and the overall complication rate was 0% (0 out of 25) and 32% (8 out of 25) (p=0.02) in the ultrasound guided and the landmark technique group respectively.Conclusion: Ultrasound guided central venous catheterization of internal jugular vein is comparable to the landmark technique in terms of number of attempts and the time required for successful cannulation. Ultrasound guided technique is much safer than the landmark technique to reduce the overall complications rate during central venous cannulation.

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