A real-time ultrasound-guided supraclavicular approach to the brachiocephalic vein to prevent Hickman catheter bending and occlusion

The need of central vein cannulation has been increased since the increased case of critical patients and patients underwent high-risk patients. Supraclavicular approach of central vein cannulation is an alternative approach to central vein cannulation due to fewer anatomical variance, good longitudinal vein view, better visualization of needle during procedure, clear demarcation of landmarks, larger target area, better patient comfort, and fewer complications. This case study presents an ultrasound guided central vein cannulation using supraclavicular approach in 30 year old male patient diagnosed with septic shock, anemia, trombcytopenia, and electrolyte imbalance post laparotomy. The indication of central vein cannulation in the patient was to deliver volume resuscitation, to provide emergency vein access, to provide nutritional support, to deliver chemically caustic agents, and central vein pressure monitoring.

Download Full-text

A Retrospective Analysis of the Clinical Effectiveness of Supraclavicular, Ultrasound-guided Brachiocephalic Vein Cannulations in Preterm Infants

Anesthesiology ◽

10.1097/aln.0000000000001871 ◽

2018 ◽

Vol 128 (1) ◽

pp. 38-43 ◽

Cited By ~ 30

Author(s):

Christian Breschan ◽

Gudrun Graf ◽

Robert Jost ◽

Haro Stettner ◽

Georg Feigl ◽

...

Keyword(s):

Retrospective Analysis ◽

Real Time ◽

Preterm Infants ◽

Ultrasound Guidance ◽

Clinical Effectiveness ◽

Brachiocephalic Vein ◽

Ultrasound Probe ◽

Ultrasound Guided ◽

The Right ◽

Axis View

Abstract Background The aim of this retrospective analysis was to evaluate the clinical effectiveness of the supraclavicular ultrasound-guided cannulation of the brachiocephalic vein in preterm infants. Methods The ultrasound probe was placed in the supraclavicular region so as to obtain the optimum sonographic long-axis view of the brachiocephalic vein. By using a strict in-plane approach the brachiocephalic vein was cannulated by advancing a 22- or 24-gauge iv cannula from lateral to medial under the long axis of the ultrasound probe under real-time ultrasound guidance into the vein. Results One hundred and forty-two cannulations in infants weighing between 0.59 and 2.5 kg (median: 2.1; CI: 2.0 to 2.2) were included. Ultimate success rate was 94% (134 of 142). One cannulation attempt was required in 100 (70%) patients, two attempts in 21 (15%), and three attempts in 13 (9%). The smaller the weight of the infant the more attempts were needed. More attempts also were needed for the right brachiocephalic vein, which was primarily targeted in 75 (53%) neonates. One (1%) inadvertent arterial puncture was noted. Conclusions This supraclavicular, in-plane, real-time, ultrasound-guided cannulation of the brachiocephalic vein seems to be a convenient and effective method to insert central venous catheters in preterm infants.

Download Full-text

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

The Journal of Vascular Access ◽

10.1177/11297298211008084 ◽

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.

Download Full-text

Real-time in-plane ultrasound-guided supraclavicular approach to subclavian vein cannulation in cardiac surgery: An underused approach

Egyptian Journal of Anaesthesia ◽

10.1016/j.egja.2013.11.001 ◽

2014 ◽

Vol 30 (2) ◽

pp. 175-180 ◽

Cited By ~ 2

Author(s):

Tarek Marei

Keyword(s):

Cardiac Surgery ◽

Real Time ◽

Subclavian Vein ◽

Ultrasound Guided ◽

Supraclavicular Approach ◽

Vein Cannulation

Download Full-text

Ultrasound Guided Brachiocephalic Vein Cannulation using Supraclavicular Approach

Journal of Health and Medical Sciences ◽

10.31014/aior.1994.04.04.187 ◽

2021 ◽

Vol 4 (4) ◽

Author(s):

Kris Chandra ◽

◽

M. Budi Kurniawan

Keyword(s):

Electrolyte Imbalance ◽

Patient Comfort ◽

Brachiocephalic Vein ◽

Central Vein ◽

Target Area ◽

Ultrasound Guided ◽

Supraclavicular Approach ◽

Vein Cannulation ◽

Vein Access ◽

Critical Patients

The need of central vein cannulation has been increased since the increased case of critical patients and patients underwent high-risk patients. Supraclavicular approach of central vein cannulation is an alternative approach to central vein cannulation due to fewer anatomical variance, good longitudinal vein view, better visualization of needle during procedure, clear demarcation of landmarks, larger target area, better patient comfort, and fewer complications. This case study presents an ultrasound guided central vein cannulation using supraclavicular approach in 30 year old male patient diagnosed with septic shock, anemia, trombcytopenia, and electrolyte imbalance post laparotomy. The indication of central vein cannulation in the patient was to deliver volume resuscitation, to provide emergency vein access, to provide nutritional support, to deliver chemically caustic agents, and central vein pressure monitoring.

Download Full-text