scholarly journals Comparative Analysis of Ultrasound Guided Central Venous Catheterization Compared to Blind Catheterization

PRILOZI ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Darko Sazdov ◽  
Marija Jovanovski Srceva ◽  
Zorka Nikolova Todorova
Keyword(s):  
Real Time ◽  
Complication Rate ◽  
Ultrasound Guidance ◽  
Central Venous Catheterization ◽  
Femoral Vein ◽  
Venous Catheter ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Venous Catheterization ◽  
A Prospective Study

Abstract 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, pneumothorax and hematoma formation were the main outcome measures. Results: The catheterization using the landmark method was successful in 90.5% of patients, 60.5% of which during the first attempt. The cannulation using real-time ultrasound guidance was successful in 98% of patients with a first pass success of 77%. The complication rate with the landmark method was 14.5% versus 4% with real-time ultrasound guidance p<0.05(p=0.0008). Conclusion: Real-time ultrasound guidance improves success, decreases number of attempts, decreases average time to the return of blood and reduces mechanical complications rate.

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 Identification and correction of guide wire malposition during internal jugular cannulation with ultrasound

CJEM ◽  
2007 ◽  
Vol 9 (02) ◽  
pp. 131-132 ◽  
Author(s):  
Michael B. Stone
Keyword(s):  
Real Time ◽  
Ultrasound Guidance ◽  
Central Venous Catheterization ◽  
Guide Wire ◽  
Venous Catheter ◽  
Central Venous ◽  
Venous Catheterization ◽  
Procedural Complications ◽  
Introducer Needle ◽  
Wire Resistance

ABSTRACT Real-time ultrasound guidance for central venous catheterization increases success and reduces procedural complications. I describe a case in which guide wire resistance was encountered and real-time ultrasound visualization of the guide wire facilitated correction of guide wire malposition. No additional passes of the introducer needle were necessary and the chances of inadvertent carotid artery puncture or pneumothorax were therefore reduced. The technique described here may prove valuable when guide wire resistance is encountered while placing a central venous catheter.

Pre- and post-review of a standardized ultrasound-guided central venous catheterization curriculum evaluating procedural skills acquisition and clinician confidence

2019 ◽  
Vol 21 (4) ◽  
pp. 440-448 ◽  
Author(s):  
Timothy R Spencer ◽  
Amy J Bardin-Spencer
Keyword(s):  
Central Venous Catheter ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous Catheter Insertion ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Clinical Simulation ◽  
Venous Catheterization ◽  
Simulation Based

Background: To evaluate novice and expert clinicians’ procedural confidence utilizing a blended learning mixed fidelity simulation model when applying a standardized ultrasound-guided central venous catheterization curriculum. Methods: Simulation-based education and ultrasound-guided central venous catheter insertion aims to provide facility-wide efficiencies and improves patient safety through interdisciplinary collaboration. The objective of this quality improvement research was to evaluate both novice (<50) and expert (>50) clinicians’ confidence across 100 ultrasound-guided central venous catheter insertion courses were performed at a mixture of teaching and non-teaching hospitals across 26 states within the United States between April 2015 and April 2016. A total of 1238 attendees completed a pre- and post-survey after attending a mixed method clinical simulation course. Attendees completed a 4-h online didactic education module followed by 4 h of hands-on clinical simulation stations (compliance/sterile technique, needling techniques, vascular ultrasound assessment, and experiential complication management). Results: The use of a standardized evidence-based ultrasound-guided central venous catheter curriculum improved confidence and application to required clinical tasks and knowledge across all interdisciplinary specialties, regardless of level of experience. Both physician and non-physician groups resulted in statistically significant results in both procedural compliance ( p < 0.001) and ultrasound skills ( p < 0.001). Conclusion: The use of a standardized clinical simulation curriculum enhanced all aspects of ultrasound-guided central venous catheter insertion skills, knowledge, and improved confidence for all clinician types. Self-reported complications were reported at significantly higher rates than previously published evidence, demonstrating the need for ongoing procedural competencies. While there are growing benefits for the role of simulation-based programs, further evaluation is needed to explore its effectiveness in changing the quality of clinical outcomes within the healthcare setting.

Accidental guide wire migration and late percutaneous externalization after central venous catheterization

2021 ◽  
pp. 112972982110548
Author(s):  
Petra Cristina van den Bogert ◽  
Walter Junior Boim de Araujo ◽  
Viviane Gomes Milgioransa Ruggeri ◽  
Filipe Carlos Caron ◽  
Fabiano Luiz Erzinger ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Guide Wire ◽  
Femoral Vein ◽  
Invasive Procedure ◽  
Venous Catheter ◽  
Hemodynamic Instability ◽  
Central Venous ◽  
Post Discharge ◽  
Venous Catheterization ◽  
The Right

A 70-year-old man was admitted to the emergency department with recent spontaneous externalization of a metallic device from his right inner thigh. He had been experiencing mild local pain for 2 weeks and had a recent hospitalization due to cardiogenic hemodynamic instability, requiring a central venous catheter placement in his right internal jugular vein 3 months earlier. Doppler ultrasound confirmed the intravascular foreign body hypothesis as a guidewire was identified inside the right femoral vein, associated with femoropopliteal venous thrombosis. The guidewire was successfully removed percutaneously through simple manual traction guided by radioscopy. The patient was discharged the following day on oral anticoagulation with rivaroxaban. On outpatient follow-up 4 weeks post discharge, he had no complaints in the right lower limb except for slight swelling. Central venous catheterization is a common invasive procedure that, although unquestionably safe and well stablished in medical practice, can lead to serious complications when performed without proper technique.

scholarly journals Cannulation of the subclavian vein using real-time ultrasound guidance

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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