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

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.

scholarly journals Central Venous Catheter Insertion: A Scoring System for Evaluation of Both the Procedure and the Operator (CVCI Score/Gaber Score)

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sayed Gaber ◽  
Ahmed Yehia ◽  
Beshoy Nabil ◽  
Ahmed Samir
Keyword(s):  
Scoring System ◽  
Ultrasound Guidance ◽  
Venous Catheter ◽  
Central Venous ◽  
Ultrasound Technique ◽  
Group A ◽  
Group B ◽  
Landmark Technique ◽  
Ultrasound Group ◽  
New Scoring

Introduction. Currently, there is no method to assess the performance while inserting a central venous catheter. We suggest a new scoring system for evaluation of both the technique as well as the operator, and then we applied it for the comparison between the landmark and ultrasound techniques to assess its validity. Methods. Four hundred patients were divided into two equal groups: group (A): internal jugular vein (IJV) and group (B): subclavian vein (SV). The landmark technique and the ultrasound guidance were used equally (100 patients for each) in both groups. Results. In group (A), 20% of patients in the landmark group achieved score 4, while 82% of patients in the ultrasound group achieved the same score. This suggests that the ultrasound technique for catheterization of IJV decreased overall complications and improved the success rate. In group (B), there were 70% of patients in the landmark group who achieved score 5, while 49% of patients in the ultrasound group achieved the same score which proposes that the landmark technique might be deceptively better than the ultrasound technique for catheterization of SV. This could be because the time required for catheterization of SV by the ultrasound technique was longer than that in the landmark technique. Overall complications of 15% with the landmark technique vs. 2% with ultrasound guidance in this group of patients are not only statistically significant but also increase morbidity and mortality with a highly invasive procedure. Complications and their incidences are by far more significant than seconds of time. Our results suggest that the ultrasound technique could decrease the incidence of overall complications, but it is time-consuming in group (B). These results support the validity of our new scoring system. Conclusion. We suggest a new scoring system for CVC insertion that can be used for evaluation of both the technique and the operator. It can evaluate the performance of junior staff and follow their progress. It can be applied in the medical and critical care practice as well as the quality management privileges and protocols.

scholarly journals TO COMPARE CENTRAL VENOUS CATHETER AND PERIPHERAL INTRAVENOUS CATHETER IN PATIENTS OF LAPAROTOMY: AN OBSERVATIONAL COMPARATIVE STUDY

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Ketan. P. Prajapati ◽  
Rajan B Somani ◽  
Soham V. Shah
Keyword(s):  
Central Venous Catheter ◽  
Life Span ◽  
Complication Rate ◽  
Venous Catheter ◽  
Intravenous Catheter ◽  
Central Venous ◽  
Peripheral Intravenous Catheter ◽  
Group A ◽  
The Mean ◽  
Group B

Background: The laparotomy is one of the major surgery require ample amount of intravenous fluids administration, blood transfusion ,and sometime parental nutrition, repeated blood sampling to monitor patients condition. These all things fulfilled by either use of peripheral intravenous catheter or central venous catheter. Both of these intravenous catheters are compared on basis of their life span, hospital stay of the patient, and their complications to evaluate the efficacy of both in patients undergoing laparotomy. Methods: An observational comparative study was conducted among 50 patients of laparotomy in the department of general surgery, sir t hospital Bhavnagar. All patients were randomly assigned to two groups A and B. Patients of group A were subjected to central venous catheter and patients of group b were subjected to peripheral intravenous catheter. Results: The mean of hospital stay of patients in group a was 20.4 (± 4.9) and group b was 15.4 (± 6.12) . The mean life span of catheter was 18.8 ± 4.25 days in group A and 6.04 ± 1.947 days in group B. Rate of major complication in group A was 12% as compare to group B having 40% complication rate. Rate of intermediate complication in group A was 20% as compare to group B having 72% complication rate. . Rate of minor complication in group A was 8% as compare to group B having 56% complication rate. Rate of overall complication in group A was 28% as compare to group B having 72% complication rate. Conclusion: Life span of central venous catheter is greater as compare to the peripheral intravenous catheter and rate of complications is more in patients with peripheral intravenous catheter. Keywords:  Central Venous Catheter, Peripheral Intravenous Catheter, Laparotomy

scholarly journals Unusual Complications of Ultrasound Guided Central Venous Cannulation

2019 ◽  
Author(s):  
Sonu Sama ◽  
Sanjay Agarwal ◽  
Vijay Adabala ◽  
Michael Leonard Anthony
Keyword(s):  
Continuous Monitoring ◽  
Ultrasound Guidance ◽  
Venous Catheter ◽  
Venous Cannulation ◽  
Central Venous Cannulation ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Common Procedure ◽  
Open Surgical Procedure ◽  
Landmark Technique

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.

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

2017 ◽  
Vol 18 (4) ◽  
pp. 328-333 ◽  
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.

Precision in Central Venous Catheter Tip Placement: A Review of the Literature

2010 ◽  
Vol 15 (3) ◽  
pp. 112-125 ◽  
Author(s):  
Russell Hostetter ◽  
Nadine Nakasawa ◽  
Kim Tompkins ◽  
Bradley Hill
Keyword(s):  
Central Venous Catheter ◽  
Selection Criteria ◽  
Weighted Average ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip ◽  
Tip Position ◽  
Landmark Technique ◽  
The Ideal

Abstract Background: Long term venous catheters have been used to deliver specialized therapies since 1968. The ideal tip position of a central venous catheter provides reliable venous access with optimal therapeutic delivery, while minimizing short-and long-term complications. Ideal position limits have evolved and narrowed over time, making successful placement difficult and unreliable when depending exclusively on the landmark technique. Objective: To review and analyze contemporary literature and calculate an overall accuracy rate for first attempt placement of a PICC catheter in the ideal tip position. Methods: Key PICC placement terms were used to search the database PubMED-indexed for MEDLINE in June and October, 2009. The selection of studies required: a patient cohort without tip placement guidance technology; a documented landmark technique to place catheter tips; data documenting initial catheter placement and, that the lower third of the SVC and the cavo-atrial junction (CAJ) were included in the placement criteria. With few exceptions, articles written between 1993 and 2009 met the stated selection criteria. A composite of outcomes associated with tip placement was analyzed, and an overall percent proficiency of accurate catheter tip placement calculated. Results: Nine studies in eight articles met the selection criteria and were included for analysis. Rates of first placement success per study ranged from 39% to 75%, with the majority (7/9) being single center studies. The combined overall proficiency of these studies calculated as a weighted average was 45.87%.

scholarly journals A Study of Malposition of Central Venous Catheter – A Comparative Study between Ultrasound Guided and Anatomical Landmark Technique

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

Novel Educational Module for Subclavian Central Venous Catheter Insertion Using Real-Time Ultrasound Guidance

2015 ◽  
Vol 72 (6) ◽  
pp. 1217-1223 ◽  
Author(s):  
Andrew W.L. Bayci ◽  
Jimmi Mangla ◽  
Christina S. Jenkins ◽  
Felicia A. Ivascu ◽  
James M. Robbins
Keyword(s):  
Central Venous Catheter ◽  
Real Time ◽  
Ultrasound Guidance ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous Catheter Insertion ◽  
Central Venous ◽  
Educational Module
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