Unusual Complications of Ultrasound Guided Central Venous Cannulation

Central venous catheter (CVC) insertion is a common procedure in operation theaters and intensive care units (ICU). The procedure is performed through anatomical landmark technique, open surgical procedure, and ultrasound-assisted insertion. In the 1990s, ultrasound guidance of CVC insertion has been advocated as a means to reduce mechanical complications and placement failures compared with the landmark technique. Still CVC complications can be related to insertion, indwelling, or extraction. There is a need for continuous monitoring to avoid possible risk factors so as to minimize the morbidity and mortality.

Download Full-text

Ultrasound-Guided Subclavian Vein Cannulation in Neonate via Supraclavicular Approach

Case Reports in Anesthesiology ◽

10.1155/2017/9789427 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Onur Balaban ◽

Tayfun Aydın

Keyword(s):

Subclavian Vein ◽

Ultrasound Guidance ◽

Jugular Vein ◽

Venous Cannulation ◽

Central Venous Cannulation ◽

Ultrasound Guided ◽

Central Venous ◽

Supraclavicular Approach ◽

Vein Cannulation ◽

Landmark Technique

Central venous cannulation of infants may be challenging. Ultrasonography is recommended and has been found superior to classic landmark technique in pediatric central venous cannulation. The cannulation of the subclavian vein using supraclavicular approach under real-time ultrasound guidance is a novel technique. It may have advantages over ultrasound-guided jugular vein cannulation in specific patients. We report a case of 3200-gram 20-day-old anencephalic neonate who had a diffuse generalized edema. The neonate was cannulated successfully via subclavian vein using supraclavicular approach under ultrasound guidance.

Download Full-text

Ultrasound guided central venous cannulation in ICU: Retrospective analysis of a single center experience

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v9i1.29166 ◽

2020 ◽

Vol 9 (1) ◽

pp. 34-36

Author(s):

Gentle S. Shrestha ◽

Manjit Shrestha ◽

Bibeka Shrestha

Keyword(s):

Ultrasound Guidance ◽

Femoral Vein ◽

Insertion Site ◽

Venous Cannulation ◽

Central Venous Cannulation ◽

Single Center ◽

Ultrasound Guided ◽

Central Venous ◽

Common Procedure ◽

Single Center Experience

Background and Aims: Central venous cannulation is a common procedure in intensive care unit. Use of ultrasound guidance can decrease complications and increase successful cannulations. Methods: Patients who underwent ultrasound guided central venous cannulation over a duration of one year, in a single center, were analyzed retrospectively. Results: A total of 101 patients were analyzed. Internal jugular vein was cannulated in 84 (83.2%) and femoral vein was cannulated in 17 (16.8%) patients. Cannulation was successful in all cases. Elective cannulation was performed in 80 (79.2%) of patients and emergency cannulation was performed in 21 (20.8%) patients. Platelet count was less than 50000/cu mm in 30 (29.7%) patients and prothrombin time was more than 13 seconds in 84 (83.2%) patients. Cannulation was successfully performed in first attempt in 99 (98%) patients. None of the patients had arterial puncture, major bleeding, pneumothorax, arrhythmias or catheter malposition. One patient developed hematoma at the catheter insertion site. Conclusions: When performed by an experienced operator, ultrasound guidance can enhance safety and improve success for central venous cannulation.

Download Full-text

THE SUCCESS OF ULTRASOUND GUIDED INSERTION OF CENTRAL VENOUS CATHETER VERSUS LANDMARK TECHNIQUE

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.3135 ◽

2021 ◽

Vol 71 (1) ◽

Author(s):

Bilal Munir ◽

Fahim Ullah Naz ◽

Salman Saleem ◽

Amna Khalid ◽

Adnan Aqil Khan ◽

...

Keyword(s):

Central Venous Catheter ◽

Ultrasound Guidance ◽

Venous Catheter ◽

Military Hospital ◽

Primary Study ◽

Ultrasound Guided ◽

Central Venous ◽

Group A ◽

Group B ◽

Landmark Technique

Objective: Central venous catheterization is an important skill for doctors working in the departments ofmedicine, surgery, critical care, anesthesiology, and emergency. The Agency for Healthcare Research and Quality, USA named ultrasound guidance of central venous catheter placement as one of 11 most underutilized practices that can enhance patient safety with greatest strength of evidence to provide clear opportunities for safety improvement. In this study, we compare the success of ultrasound-guided insertion of central venous catheter versus landmark technique. Study Design: Randomized controlled clinical trial. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi, from Jul to Dec 2016.Methodology: One hundred twenty patients admitted in its wards and undergone CVC were included. Patientswere divided into group A & group B containing 60 patients each. In ‘group A’ CVC was done with ultrasoundassistance while in ‘group B’ CVC was done with landmark technique. The primary study outcome was No. ofattempts at which CVC was done. Results: In this study, 120 patients were enrolled. There was no difference in demographic data comparison.Success rate was found to be 28 (46.67%) in-group A while 16 (26.67%) in-group B with the p-value of 0.042 which is significant. Conclusion: We concluded that CVC with ultrasound guidance is more successful than landmark technique.

Download Full-text

Transitioning from anatomic landmarks to ultrasound guided central venous catheterizations: guidelines applied to clinical practice

The Journal of Vascular Access ◽

10.5301/jva.5000756 ◽

2017 ◽

Vol 18 (4) ◽

pp. 328-333 ◽

Cited By ~ 1

Author(s):

Rodrigo Oom ◽

Rui Casaca ◽

Rita Barroca ◽

Sara Carvalhal ◽

Catarina Santos ◽

...

Keyword(s):

Ultrasound Guidance ◽

Venous Catheter ◽

High Volume ◽

Ultrasound Guided ◽

Central Venous ◽

Anatomic Landmarks ◽

Effective Technique ◽

Oncological Center ◽

Landmark Technique ◽

Prospective Database

Introduction 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. Methods 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. Results 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%) and arterial puncture was registered in 41 cases (3.5%). An increasing use of USG for placing CICCs was planned and observed over the years and, in the last year of the study, 67.3% of the CICC placements were with USG. Conclusions CICC placement with USG is a safe and effective technique. Despite some resistance that is observed, these results support that it is worth following the guidelines that advocate the use of the USG in the placement of CICC.

Download Full-text

Faculty of 1000 evaluation for Ultrasound-guided central venous cannulation is superior to quick-look ultrasound and landmark methods among inexperienced operators: a prospective randomized study.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.718106938.793485701 ◽

2013 ◽

Author(s):

Bernard Wittels

Keyword(s):

Randomized Study ◽

Prospective Randomized Study ◽

Venous Cannulation ◽

Central Venous Cannulation ◽

Ultrasound Guided ◽

Central Venous

Download Full-text

Use of saline infusion instead of gel for ultrasound-guided (USG) central venous cannulation

Acta Anaesthesiologica Scandinavica ◽

10.1111/j.1399-6576.2008.01614.x ◽

2008 ◽

Vol 52 (5) ◽

pp. 721-721 ◽

Cited By ~ 1

Author(s):

R. Sinha ◽

J. Punj ◽

R. Pandey

Keyword(s):

Saline Infusion ◽

Venous Cannulation ◽

Central Venous Cannulation ◽

Ultrasound Guided ◽

Central Venous

Download Full-text

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

Download Full-text

Simulation-based ultrasound-guided central venous cannulation training program

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502014000200010 ◽

2014 ◽

Vol 29 (2) ◽

pp. 132-144 ◽

Cited By ~ 6

Author(s):

Rafael Denadai ◽

Andreia Padilha Toledo ◽

Danielle Milani Bernades ◽

Felipe Daldegan Diniz ◽

Fernanda Brandão Eid ◽

...

Keyword(s):

Training Program ◽

Venous Cannulation ◽

Central Venous Cannulation ◽

Ultrasound Guided ◽

Central Venous ◽

Simulation Based

Download Full-text

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

Journal of Society of Anesthesiologists of Nepal ◽

10.3126/jsan.v3i1.14636 ◽

2016 ◽

Vol 3 (1) ◽

pp. 18-21 ◽

Cited By ~ 2

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.

Download Full-text