Real-time ultrasound-guided subclavian vein cannulation in cardiac surgery: comparison between short-axis and long-axis techniques

Real-time ultrasound-guided subclavian vein cannulation in intensive care patients has higher success and lower complication rates compared to the traditional landmark method. Level of evidence: 1B (RCT with narrow CIs)

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Real-Time Ultrasound-Guided Subclavian Vein Cannulation Versus the Landmark Method in Critical Care Patients

Survey of Anesthesiology ◽

10.1097/sa.0b013e31824bbb78 ◽

2012 ◽

Vol 56 (2) ◽

pp. 98

Author(s):

Mariantina Fragou ◽

Andreas Gravvanis ◽

Vasilios Dimitriou ◽

Apostolos Papalois ◽

Gregorios Kouraklis ◽

...

Keyword(s):

Critical Care ◽

Real Time ◽

Subclavian Vein ◽

Ultrasound Guided ◽

Vein Cannulation ◽

Critical Care Patients

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Cannulation of the subclavian vein using real-time ultrasound guidance

Journal of the Intensive Care Society ◽

10.1177/1751143720901403 ◽

2020 ◽

Vol 21 (4) ◽

pp. 349-354

Author(s):

Thomas W Davies ◽

Hugh Montgomery ◽

Edward Gilbert-Kawai

Keyword(s):

Real Time ◽

Complication Rate ◽

Subclavian Vein ◽

Ultrasound Guidance ◽

Central Venous Access ◽

Venous Access ◽

Ultrasound Guided ◽

Central Venous ◽

Vein Cannulation

Cannulation of the subclavian vein has many advantages when compared to other anatomical sites for central venous access. Difficulty in its ultrasonic visualisation, and the perceived consequent ‘higher’ complication rate, mean that this approach has fallen out of favour. This barrier, however, may now have disappeared. In this article, we discuss the indications, contraindications and complications associated with subclavian vein cannulation, and present an ultrasound-guided approach to infraclavicular subclavian cannulation.

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Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: A prospective randomized study*

Critical Care Medicine ◽

10.1097/ccm.0b013e318218a1ae ◽

2011 ◽

Vol 39 (7) ◽

pp. 1607-1612 ◽

Cited By ~ 205

Author(s):

Mariantina Fragou ◽

Andreas Gravvanis ◽

Vasilios Dimitriou ◽

Apostolos Papalois ◽

Gregorios Kouraklis ◽

...

Keyword(s):

Critical Care ◽

Real Time ◽

Subclavian Vein ◽

Randomized Study ◽

Prospective Randomized Study ◽

Ultrasound Guided ◽

Vein Cannulation ◽

Critical Care Patients

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Study on Clinical Application of Different Ultrasound-Guided Planar Techniques in Minimally Invasive Percutaneous Nephrolithotomy

Surgical Innovation ◽

10.1177/1553350621997795 ◽

2021 ◽

pp. 155335062199779

Author(s):

Difu Fan ◽

Leming Song ◽

Monong Li ◽

Chunxiang Luo ◽

Xiaohui Liao ◽

...

Keyword(s):

Minimally Invasive ◽

Real Time ◽

Clinical Application ◽

Short Axis ◽

Ultrasound Guided ◽

Out Of Plane ◽

Minimally Invasive Percutaneous Nephrolithotomy ◽

Plane Group ◽

Plane Technique ◽

Guided Puncture

Objective. The objective is to explore the clinical application value of ultrasound long- and short-axis planar technology in real-time guided puncture in minimally invasive percutaneous nephrology. Methods. The clinical data of 80 patients undergoing real-time ultrasound-guided minimally invasive percutaneous nephrolithotomy from September 2018 to October 2019 were analyzed. The patients were randomly divided into 2 groups with different ultrasound-guided puncture techniques, long-axis in-plane technique and short-axis out-of-plane technique. Results. Minimally invasive percutaneous nephrolithotomies under real-time ultrasound guidance were successfully completed in both groups of patients. The success rate of the first puncture in the short-axis out-of-plane group was significantly higher than that in the long-axis in-plane group, and the differences were statistically significant ( P <.05); the total puncture time in the short-axis out-of-plane group was significantly less than the long-axis in-plane group, and the differences were statistical significance ( P <.05); there was no significant difference in the single-stage stone removal rate, total percutaneous renal channels, total hospital stay, and rate of complications by the Clavien classification between the 2 groups ( P > .05). Conclusion. Ultrasound long-axis and short-axis planar technologies can achieve good clinical application results in real-time guided puncture to establish percutaneous renal channels during minimally invasive percutaneous nephrolithotomy. Compared with the long-axis in-plane technique, the short-axis out-of-plane technique can shorten the puncture time and improve the success rate of the first puncture.

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A Study of Malposition of Central Venous Catheter – A Comparative Study between Ultrasound Guided and Anatomical Landmark Technique

Birat Journal of Health Sciences ◽

10.3126/bjhs.v2i3.18943 ◽

2018 ◽

Vol 2 (3) ◽

pp. 277-281

Author(s):

Lalit Kumar Rajbanshi ◽

Sambhu Bahadur Karki ◽

Batsalya Arjyal

Keyword(s):

Real Time ◽

Internal Jugular Vein ◽

Subclavian Vein ◽

Jugular Vein ◽

Venous Catheter ◽

Anatomical Landmark ◽

Ultrasound Guided ◽

Central Venous ◽

Catheter Tip ◽

Landmark Technique

Introduction: Central venous catheterization is a routine procedure for long-term infusion therapy and central venous pressure measurement. Sometimes, the catheter tip may be unintentionally placed at the position other than the junction of superior vena cava and right atrium. This is called malposition and can lead to erroneous pressure measurement, increase risk of thrombosis, venous obstruction or other life threatening complications like pneumothorax, cardiac temponade.Objectives: This study aimed to observe the incidence of the malposition and compare the same between ultrasound guided catheterization and blind anatomical landmark technique.Methodology: This study was a prospective comparative study conducted at the intensive care unit of Birat Medical College and Teaching Hospital for two-year duration. All the catheterizations were done either with the use of real time ultrasound or blind anatomical landmark technique. The total numbers of central venous catheterization, the total incidences of malposition were observed. Finally the incidences were compared between real time ultrasound guided technique and blind anatomical landmark technique.Results: In two-year duration of the study, a total of 422 central venous cannulations were successfully done. The real time ultrasound was used for 280 cannulations while blind anatomical landmark technique was used for 162 patients. The study observed various malposition in 36 cases (8.5%). The most common malposition was observed for subclavian vein to ipsilateral internal jugular vein (33.3%) followed by subclavian to subclavian vein (27.8%) and internal jugular to ipsilateral subclavian vein (16.7%). In four patients the catheter had a reverse course in the internal jugular vein while the tip was placed in pleural cavity in three cannulations. There was coiling of the catheter inside left subclavian vein in one patient. The malposition was significantly reduced with the use of the real time ultrasound (P< 0.001). However there is no significant difference in the incidence of the various malposition between ultrasound guidance technique and blind anatomical landmark technique when compared individually.Conclusion: The malposition of the central venous catheter tip was common complication with the overall incidence of 8.5%. The most common malposition was subclavian vein to internal jugular vein. The use of real time ultrasound during the catheterization procedure can significantly reduced the risk of malposition.Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 277-281

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