scholarly journals Subclavian vein catheterization: Comparative evaluation of supraclavicular versus infraclavicular approach in oncology patients

2021 ◽  
Vol 8 (3) ◽  
pp. 408-412
Author(s):  
Amit Bodkhe ◽  
Avanti Purohit ◽  
Chitra Pitale ◽  
Hemant Bhirud
Keyword(s):  
Success Rate ◽  
Subclavian Vein ◽  
Venous Catheter ◽  
Access Time ◽  
Brachiocephalic Vein ◽  
Seldinger Technique ◽  
P Value ◽  
Entire Study ◽  
Supraclavicular Approach ◽  
Vein Catheterization

The subclavian vein is the preferred site for central venous catheter insertion because of its several advantages. Infraclavicular is the commonly used approach while supraclavicular is less popular approach for catheterizing the subclavian vein. The aim of the study was to compare supraclavicular and infraclavicular approach of subclavian vein catheterization in terms of number of attempts, success rate, access time for catheterization and to record the complications associated with the procedure. In this study, 120 patients of inclusion criteria were placed either in group supraclavicular (SC) or group infraclavicular (IC) for subclavian vein catheterization using modified Seldinger technique under general or local anaesthesia.Chi square test was used to compare success rate and independent T test for access time of catheterization between two groups. First attempt success rate in group SC was 81.66% and in group IC was 66.66%. But overall success rate was 93.33% in group SC, whereas it was 90% in group IC. This was not statistically significant with p value of 0.5. Time taken for successful catheterization was 252.98 ± 76.27 seconds in group SC and 314.98 ± 121.28 seconds in group IC. This was statistically significant with p value of 0.001.Right brachiocephalic vein tear was the only complication in entire study which occurred in group IC. Subclavian vein catheterization via supraclavicular approach was a faster approach than infraclavicular, whereas both were comparable in terms of success rate.

Comparison Between Supraclavicular and Infraclavicular Approach in Subclavian Vein Catheterization in Tertiary Center of Nepal

2020 ◽  
Vol 3 (2) ◽  
pp. 111-115
Author(s):  
Robin Khapung ◽  
Jeju Nath Pokharel ◽  
Kiran Kumar KC ◽  
Kripa Pradhan ◽  
Uma Gurung ◽  
...  
Keyword(s):  
Success Rate ◽  
Subclavian Vein ◽  
Guide Wire ◽  
Femoral Vein ◽  
Access Time ◽  
P Value ◽  
Central Vein ◽  
Chi Square ◽  
Tertiary Center ◽  
Vein Catheterization

Introduction: Central vein catheterization can be introduced in subclavian vein (SCV), internal jugular vein or femoral vein for volume resuscitation and invasive monitoring technique. Due to anatomical advantage and lesser risk of infection subclavian vein is preferred. Either supraclavicular (SC) or infraclavicular (IC) approach could be used for subclavian vein catheterization. The aim of the study was to compare SC and IC approach in ease of catheterization of SCV and record the complications present if any. Methods and materials: This was a hospital based comparative, interventional study conducted from November 2016 to October 2017 in Operation Theater in Bir Hospital. In this study, 70 patients for elective surgical cases meeting the inclusion criteria were randomly enrolled. Then samples were equally divided by lottery into either supraclavicular or infraclavicular approach groups. The Access time, cannulation success rate, attempts made for successful cannulation of vein, easy insertion of catheter and guide wire, approximate inserted length of catheter and associated complications in both groups were recorded. Data was entered in statistical software SPSS 16. Chi-square test was used. P value < 0.05 was considered significant. Results: The mean access time in group SC for SCV catheterization was 2.12 ± 0.81 min compared to 2.83 ± 0.99 min in group IC (p-value= 0.002). The overall success rate in catheterization of the right SCV using SC approach (34 / 35) was better as compared with group IC (33 / 35) using IC approach. First successful attempt in the SC group was 74.28% as compared with 57.14% in the IC group. Conclusion: The SC approach of SCV catheterization can be considered alternative to IC approach in terms of landmark accessibility, success rate and rate of complications.

scholarly journals Influence of arm position during infraclavicular subclavian vein catheterization in coronary artery bypass graft surgery

2018 ◽  
Vol 10 (4) ◽  
pp. 192-196 ◽  
Author(s):  
Masoud Tarbiat ◽  
Maryam Davoudi ◽  
Sayed Ahmadreza Salimbahrami
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Success Rate ◽  
Subclavian Vein ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Neutral Group ◽  
Significant Difference ◽  
Vein Catheterization

Introduction: Percutaneous subclavian vein catheterization via infraclavicular approach is one of the most widely used cannulation techniques for inserting catheters into a central vein. The aim of this study was to evaluate influence of arm position during infraclavicular subclavian vein catheterization with landmark-based technique in coronary artery bypass graft (CABG) surgery. Methods: Between September 2017 and June 2018, this prospective randomized clinical trial was performed in 320 patients. The patients were randomly assigned to the Neutral group (the arms kept by the side) or Abduction group (the arm was abducted to 90°). The success and complication rates were compared in the two groups. The data were analyzed using SPSS software. Results: In the first attempt of subclavian vein cannulation, the success rate had no significant difference between the two groups (P = 0.185). In the second attempt of catheterization, the success rate in Abduction group (40.5%) was lower than Neutral group (81.2%). The overall success rate in two attempts were (84.4%) in the Abduction group and (96.2%) in the Neutral group. There was a significant difference between two groups in the second and overall success rates (P = 0.0001). In 34 (10.6%) patients, subclavian artery puncture occurred, 30 (18.8%) in the Abduction group and 4 (2.5%) in the Neutral group. There was a significant difference between two groups (P = 0.0001). Pneumothorax was occurred in 15 (9.4%) in the Abduction group and 3 (1.9%) in the Neutral group. There was also a significant difference between two groups (P = 0.004). The differences in other complications on two groups were statistically insignificant. Conclusion: Compared with Abduction group, the Neutral group resulted in higher success rate and fewer subclavian artery puncture and pneumothorax. The incidences of other complications were similar on both groups.

Ultrasound-Guided Cannulation of the Brachiocephalic Vein in Neonates and Preterm Infants: A Prospective Observational Study

2017 ◽  
Vol 35 (05) ◽  
pp. 503-508 ◽  
Author(s):  
Paula Alonso-Quintela ◽  
Sandra Terroba-Seara ◽  
Aquilina Jiménez-González ◽  
Silvia Rodríguez-Blanco ◽  
José Vázquez-Martínez ◽  
...  
Keyword(s):  
Observational Study ◽  
Success Rate ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Venous Catheter ◽  
Late Complications ◽  
Brachiocephalic Vein ◽  
Success Rates ◽  
Low Weight

Introduction Percutaneous central venous catheter (CVC) insertion is a challenging procedure in neonates, especially in preterm infants. Objective This study aims to describe the technical success and safety profile of ultrasound (US)-guided brachiocephalic vein (BCV) cannulation in neonates. Methods Prospective observational study. Neonates admitted to the neonatal intensive care unit (NICU) in whom US-guided cannulation of the BCV was attempted were eligible. Outcomes included first attempt success rate, the overall success rate, the number of attempts, the cannulation time, immediate mechanical complications, catheter indwelling days, and late complications. Results A total of 40 procedures in 37 patients were included. Median weight and age at the time of cannulation were 1.85 kg (0.76–4.8) and 13 days (3–31), respectively. First attempt and overall success rates were 29 (72.5%) and 38 (95%), respectively. No major complications were observed. Catheter-associated infection rate was 2.4/1,000 catheter days. There were no difference in outcomes between low weight preterm infants (<1.5 kg) and the rest of the cohort. There was no linear relationship between weight at time of insertion and the number of puncture attempts (r = 0.250; p = 0.154) or cannulation time (r = 0.257; p = 0.142). Conclusion US-guided cannulation of the BCV may be considered in acutely ill neonates, including small preterm infants, who need a large bore CVC.

scholarly journals Insertion of a 1.9F central venous catheter via the internal jugular vein in neonates

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092538
Author(s):  
Feixiang Luo ◽  
Xiaoying Cheng ◽  
Xiaofang Lou ◽  
Qin Wang ◽  
Xiaoyan Fan ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Success Rate ◽  
Internal Jugular Vein ◽  
Neonatal Intensive Care ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Seldinger Technique ◽  
Central Venous ◽  
Minimal Trauma ◽  
The Right

Objective This study aimed to develop a technique for placing a 1.9 French (F) central venous catheter in the internal jugular vein of newborns. Methods In this retrospective study, punctures were performed with a modified ultrasound-guided Seldinger technique with 57 1.9F catheters in 48 newborns. Punctures were performed in the right internal jugular vein in 43 (75.4%) patients and in the left internal jugular vein in 14 (24.6%) patients. Results We included 33 (57.9%) boys and 24 (42.1%) girls, aged a median 38 days (range, 2–135 days). The puncture success rate was 100%. Catheterization duration was a median 14 days (range, 1–70 days). Among the catheters, 94.1% were removed after completion of therapy or upon death. Fifty-three (93%) patients experienced no complication, whereas a small amount of bleeding was observed in 2 (3.5%) patients, inflammation of puncture in 1 (1.8%) patient, and occlusion in 1 (1.8%) patient. The method of placement of 1.9F catheters in the internal jugular vein of newborns had a high success rate, with minimal trauma and few complications. Conclusions Our method of placing a 1.9F central venous catheter in the internal jugular vein is suggested for level III to VI neonatal intensive care units.

A retrospective analysis of the real-time ultrasound-guided supraclavicular approach for the insertion of a tunneled central venous catheter in pediatric patients

2021 ◽  
pp. 112972982110080
Author(s):  
Kazuhiko Nakame ◽  
Tatsuru Kaji ◽  
Shun Onishi ◽  
Masakazu Murakami ◽  
Ayaka Nagano ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Central Venous Catheter ◽  
Real Time ◽  
Pediatric Patients ◽  
Venous Catheter ◽  
Background Information ◽  
Brachiocephalic Vein ◽  
Central Venous ◽  
Supraclavicular Approach ◽  
Venous Catheterization

Purpose: Tunneled central venous catheter (tCVC) placement plays an important role in the management of pediatric patients. We adopted a real-time ultrasound (US)-guided supraclavicular approach to brachiocephalic vein cannulation. We evaluated the outcomes of tCVC placement via a US-guided supraclavicular approach. Methods: A retrospective study was performed for patients who underwent US-guided central venous catheterization of the internal jugular vein (IJV group) and brachiocephalic vein (BCV group) in our institution. The background information and outcomes were reviewed using medical records. Results: We evaluated 85 tCVC placements (IJV group: n = 59, BCV group: n = 26). Postoperative complications were recognized in 19 patients in the IJV group (catheter-related bloodstream infection (CRBSI), n = 14 (1.53 per 1000 catheter days); occlusion, n = 1 (1.7%, 1.09 per 1000 catheter days); accidental removal, n = 3 (5.2%, 0.33 per 1000 catheter days); and other, n = 1 (1.7%, 1.09 per 1000 catheter days)) and five patients in the BCV group (CRBSI, n = 2 (0.33 per 1000 catheter days); catheter damage, n = 1 (3.8%, 1.67 per 1000 catheter days); and accidental removal, n = 2 (7.7%, 0.33 per 1000 catheter days)). In the BCV group, despite that, the incidence of postoperative complications was lower ( p = 0.205) and the period of placement was significantly longer in comparison to the IJV group ( p = 0.024). Conclusion: US-guided placement of tunneled CVC though the BCV results in a low rate of postoperative complications despite longer CVC indwelling times compared to IJV insertion. Our results suggest that BCV insertion of tunneled CVC in children may offer advantages in terms of device performance and patient safety.

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