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 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.

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.

scholarly journals Ultrasound assisted catheterization of internal jugular vein

2021 ◽  
pp. 48-55
Keyword(s):  
Success Rate ◽  
Internal Jugular Vein ◽  
Vascular Access ◽  
Jugular Vein ◽  
Anatomical Variations ◽  
Central Vein ◽  
Complication Rates ◽  
Success Rates ◽  
Ultrasound Assisted ◽  
Vein Catheterization

An appropriate vascular access is always needed for the success of hemodialysis. Internal jugular vein is the safest and less complicated access in between central veins. At the same time, it is the most commonly used temporary vascular access for hemodialysis. The blind method after anatomical marking for the central vascular path is the most used technique in many centers. The use of ultrasound in the placement of hemodi-alysis catheters in the central vein increases the success rate of catheterization. Ultrasound can show IJV locali-zation, anatomical variations, the presence of thrombus in the vein, and whether the vein is open. The aim of this study is to compare the success rate and complication frequency of temporary catheters placed in the IJV with and without ultrasound for hemodialysis. A total of 124 consecutive patients who required hemodialysis catheters in Haydarpaşa Numune Trai-ning and Research Hospital between February 2012 and December 2012 were randomized to the study. The patients were divided into two groups as non USG-assisted (blindly) (Group 1) and ultrasound-assisted (Group 2). The use of ultrasound significantly increased the successful catheterization rates of both experienced specialist and resident. In addition, there was no statistical difference between the success rates between the specialist and the resident. USG-assisted vein catheterization can be performed safely, easily, quickly, more painlessly and with minimal complication rates. Catheter intervention should be performed under the guidance of USG in risky patient groups who need temporary catheters. In centers that do not have USG, especially in such risky patients, blind catheter interven-tion should not be attempted after anatomical marking. USG-assisted vein catheterization can be easily perfor-med by all clinicians and residents, since the training period is short, practical and much more safe.

scholarly journals Functional outcome of endoscopic and external dacrocystorhinostomy in a teaching hospital

2019 ◽  
Vol 5 (2) ◽  
pp. 358
Author(s):  
Arvind Varma ◽  
Sushobhan Dasgupta
Keyword(s):  
Prospective Study ◽  
Success Rate ◽  
Nasolacrimal Duct ◽  
P Value ◽  
Chi Square ◽  
Chi Square Test ◽  
Endonasal Dcr ◽  
Post Traumatic ◽  
External Dcr

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare &amp; analyse the results of two different techniques of dacrocystorhinostomy (endonasal and external) in different etiological groups.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out for nasolacrimal duct obstruction from October 2016 to October 2018 who underwent dacrocystorhinostomy by two different methods. The patient was divided into two groups one who underwent endonasal DCR (n=55) and another group who underwent external DCR (n=55). In each group they were subdivided into 3 groups on the basis of aetiology into idiopathic, post traumatic and revision cases. The results were evaluated in follow up period of 6 months. At the end of the study, decoding of the groups was done and the results were analysed statistically, using Chi Square test and student t-test, using SSPS III software. P value of less than 0.05 was considered statistically significant.</p><p class="abstract"><strong>Results:</strong> The success rate in endonasal DCR and external DCR was almost same in all the three groups (p&gt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> This prospective study shows that both the methods have almost same success rate. This study also emphasises proper case selection and interdepartmental cooperation for optimum results.</p>

scholarly journals Success rate of Nasolacrimal Duct Probing in children with Congenital Nasolacrimal Duct Obstruction after the age of one year

2021 ◽  
Vol 25 (1) ◽  
pp. 16-20
Author(s):  
Misbah Munshi ◽  
Kanwal Zareen Abbasi ◽  
Areeba Zia ◽  
Wajeeha Rasool ◽  
Maria Zubair ◽  
...  
Keyword(s):  
Success Rate ◽  
Computer Software ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
P Value ◽  
Chi Square ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
One Year

Introduction: The objective of this study was to determine the success rate of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in children after the age of one year.Materials and Methods: It was a descriptive case series conducted on 145 children presented to Ophthalmology Department, Allied Hospital, Faisalabad with CNLDO. The probing and syringing of the nasolacrimal duct were performed under general anesthesia. The patency of the nasolacrimal system was evaluated by irrigation of saline stained with pyodine through the superior punctum, flow of saline into the nose was confirmed by soaking of throat gauze with pyodine stained fluid and/or oozing of pyodine stained fluid through nose. Patients were advised topical antibiotics and steroids for 3 weeks after the probing and follow-up checkups after 6 weeks. Data were analyzed using SPSS computer software version 17.0. Effect modifier like age and gender was controlled by stratification. The post-stratification chi-square test was applied. P-value <0.05 was considered significant.Results: In our study, the frequency of success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in children between 1 to 2 years was 80.3%, children between 2 to 3 years of age were 53.1%, and children between 3 to 4 years of age were 32.4%.Conclusion: We concluded that the success rate of nasolacrimal duct probing for congenital nasolacrimal duct obstruction is higher in children after the age of one year and decreases gradually as the age progresses.

scholarly journals Incidence of Stone Retropulsion in Ureteroscopic Pneumatic Lithotripsy for lower ureteric stones by using stone cone.

2019 ◽  
Vol 26 (12) ◽  
pp. 2169-2172
Author(s):  
Khalid Hussain ◽  
Attiq-ur-Rehman Khan ◽  
Rao Nouman Ali ◽  
Maria Tariq ◽  
Salman Shahid ◽  
...  
Keyword(s):  
Success Rate ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Spiral Ct ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Pneumatic Lithotripsy ◽  
Chi Square Test

Objectives: To measure the incidence of stone Retropulsion and its complication in ureteroscopic pneumatic lithotripsy for lower ureteric stones by using stone cone. Study Design: Observational cross sectional study. Setting: Gujranwala Medical College, Gujranwala. Period: January 2017 to December 2018. Material & Methods: Consecutive simple random sampling technique was used. Total 120 patients were treated with URS pneumatic lithotripsy for single ureteric stone were enrolled in study. The diagnosis was established by plain spiral CT scan in all patients. The incidence of stone Retropulsion and complications of procedure were noted. Data was analyzed using SPSS 22.0, chi square test was used to check stratification of data, p value less than 0.05 was taken significant. Results: The stone was in lower ureter in all patients who were included in study regardless of side. The mean age of patients was 46±2.6 years and 65% (78) patients were male while 35% (42) patients were females. Success rate of 97.5% (116) achieved in patients in which stone cone was used. Conclusion: Use of stone cone gives high success rate in preventing stone Retropulsion by using pneumatic lithotripsy.

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