Ultrasound-guided central venous access for patients in the Intensive Care Unit in prone position: report of three cases

Lima, Bruno; Cheung, Linda

doi:10.1016/j.bjane.2021.10.008

Cited by 3 publications

(6 citation statements)

References 5 publications

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“…Acute kidney injury occurs in 40-60% of patients with ARDS (22,23), with 20-30% requiring RRT (23,24). The IJV has long been a preferred site for RRT-related central venous access, but descriptions of IJV cannulation in the prone position have been limited (13)(14)(15)(16)(17)(18)(19)(20). The original procedural technique for IJV CVC placement described three routes of needle entry: anterior or posterior to the SCM, and between the SCM bellies (6).…”

Section: Discussionmentioning

confidence: 99%

“…However, placement of a nontunneled hemodialysis catheter in the subclavian vein is associated with the risk of central venous stenosis (5), and specialty equipment is required for hemodialysis catheter placement in the popliteal vein (11). Reports of IJV cannulation while in the prone position have been of limited scope with a total of only 12 patients described in the literature (12)(13)(14)(15)(16)(17)(18)(19)(20). Here, we describe clinical characteristics and outcomes of 32 patients who underwent IJV cannulation primarily for hemodialysis catheter placement while in the prone position by physicians and certified nurse anesthetists experienced in supine but not prone CVC placement.…”

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confidence: 99%

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Catheterization Without Supination—A Series of 36 Prone Position Internal Jugular Vein Cannulations

Lussier

Pham

Ratti

et al. 2022

Critical Care Explorations

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OBJECTIVES: Describe the clinical characteristics and outcomes of 32 critically ill patients who underwent central venous cannulation of the internal jugular vein while in prone position. DESIGN: Retrospective cohort analysis. SETTING: Single tertiary-care urban academic safety-net hospital. PATIENTS/SUBJECTS: Patients requiring mechanical ventilation and prone positioning for severe acute respiratory distress syndrome from March 1, 2020, through March 31, 2021. INTERVENTIONS: Internal jugular vein cannulation while in the prone position. MEASUREMENTS AND MAIN RESULTS: The technique used for venous access, procedural complications, patient demographics, and clinical outcomes are described. Thirty-six prone internal jugular vein cannulations for 32 hemodialysis catheters and four central venous catheters were successfully performed in 32 patients. One immediate and one delayed pneumothorax occurred. Inhospital mortality was 88%. CONCLUSIONS: In the largest series to date, cannulation of the internal jugular vein with the patient in prone position is feasible but associated with a 6% risk of pneumothorax. Severity of illness in patients intolerant of supine positioning results in high inhospital mortality.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Catheterization Without Supination—A Series of 36 Prone Position Internal Jugular Vein Cannulations

Lussier

Pham

Ratti

et al. 2022

Critical Care Explorations

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“…In which a commendable case series has been performed, reporting 36 cases of internal jugular vein cannulation in the prone position. Since 1970, prone decubitus (PD) has been used as adjuvant therapy to treat severe hypoxia in patients with acute respiratory distress syndrome (ARDS), and now with the COVID-19 pandemic, its use has become widespread in ICUs ( 2 ).…”

Section: To the Editormentioning

confidence: 99%

“…In 2010, Sofi and Arab ( 5 ) described for the first time the placement of a VA in PD, in a patient with severe bleeding after fixation of an acetabulum fracture. In 2021, Lima and Cheung ( 2 ) published the largest case series, up to that time, of VA placed on PD. In 2022, our working group published a series of seven cases of VA in PD, three of which were placed in the internal jugular vein ( 6 ).…”

Section: To the Editormentioning

confidence: 99%

Internal Jugular Vein Cannulation in Prone Position

Salvador-Ibarra¹

2023

Critical Care Explorations

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Since 1970, prone decubitus (PD) has been used as adjuvant therapy to treat severe hypoxia in patients with acute respiratory distress syndrome (ARDS), and now with the COVID-19 pandemic, its use has become widespread in ICUs. ARDS is characterized by diffuse bilateral radiographic infiltrates, decreased respiratory compliance, small lung volumes, and severe hypoxemia. The placement of vascular access in PD seems to be feasible and safe, since, as has been described, the number of complications such as pneumothorax, bleeding, and arterial punctures are almost nil, especially when performed under ultrasound guidance. The patients who could benefit most from this procedure seem to be those with obesity, mainly with a body mass index greater than 30 kg/m 2 , in whom the return to the supine position may represent a risk of respiratory or hemodynamic deterioration.

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“…The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 13 1 LIJV Posterior Hemodialysis None Anagnostopoulos et al 14 1 RIJV Posterior CVC None Gomez-Maldonado et al 15 1 LIJV Posterior Hemodialysis None Adams and Mousa 16 1 Popliteal vein Out of plane Hemodialysis None Yang and Ng 17 1 RIJV Posterior Hemodialysis None Lima and Cheung 18 3 RIJV Anterior CVC None Salvador-Ibarra et al 19 7…”

Section: Author Contributionsmentioning

confidence: 99%

Hemodialysis vascular access in prone position for critically ill patients with ARDS

et al. 2023

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Introduction: Acute respiratory distress syndrome (ARDS) is defined in critically ill patients with acute hypoxemia and positive-pressure ventilation in association with several clinical disorders including trauma, pneumonia, sepsis, and aspiration. The prone position has been used for many years and is now recommended for patients with severe or moderate-to-severe ARDS on invasive mechanical ventilation. Acute kidney injury (AKI) is a common complication in patients with ARDS, with up to a 35% incidence rate. Initiation of Kidney Replacement Therapy (KRT) requires wise clinical judgment and collaboration between nephrologists and intensivists. A properly functioning vascular access is critical for an optimized KRT. Our institute is a national referral center for respiratory diseases. Results: We describe 11 cases of dialysis catheter placement for KRT in critically ill patients with ARDS on mechanical ventilation in prone position. The catheter was placed in the first puncture attempt in nine cases, Blood flows (Qb) achieved were 283.4 ± 20.4 ml/min during the session, in six cases the radiologic tip location was achieved in the peri cavoatrial junction; in four cases was achieved in mid to- deep right atrium. The dialysis quality standards were based on KTV and in URR; in nine cases (81.81%) KTV was in 1.3 and in all cases (100%) URR was >65%, lumen dysfunction was reported only in two cases (18.1%), but these cases did respond to mobilization maneuvers. The procedure time of placement was 29.8 min, no arterial punctures or complications were reported. Conclusions: We demonstrate that in our study hemodialysis non-tunneled catheter placement in the prone position is safe and effective. We believe this practice could be frequently used in the near future and represent an opportunity window for the training of interventional nephrologists and related areas.

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Ultrasound-guided central venous access for patients in the Intensive Care Unit in prone position: report of three cases

Cited by 3 publications

References 5 publications

Catheterization Without Supination—A Series of 36 Prone Position Internal Jugular Vein Cannulations

Catheterization Without Supination—A Series of 36 Prone Position Internal Jugular Vein Cannulations

Internal Jugular Vein Cannulation in Prone Position

Hemodialysis vascular access in prone position for critically ill patients with ARDS

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