Comparative Analysis of Ultrasound Guided Central Venous Catheterization Compared to Blind Catheterization

Abstract

introduction:Central venous catheterization is performed by the landmark method and ultrasound guided method. The purpose of the study was to compare the success, average number of attempts, average time to return of blood, and complication rate between the two methods. Material and Methods:This was a prospective study done in the Intensive Care Unit of the Acibadem Sistina Clinical Hospital, in Skopje. There were 400 patients in need of central venous catheter and they were prospectively randomized in two groups. The patients randomized in the examined-ultrasound group underwent real-time ultrasound-guided catheterization and the patients randomized in the control-landmark group were catheterized using the landmark method. Internal Jugular, Subclavian and Femoral vein were catheterized in both groups. The Overall success, success on the first attempt, time to the return of blood, number of attempts and complications at the moment of catheterization such as arterial puncture, pneumothorax and hematoma formation were the main outcome measures. results:The catheterization using the landmark method was successful in 90.5% of patients, 60.5% of which during the first attempt. The cannulation using real-time ultrasound guidance was successful in 98% of patients with a first pass success of 77%. The complication rate with the landmark method was 14.5% versus 4% with real-time ultrasound guidance p<0.05(p=0.0008). conclusion: Real-time ultrasound guidance improves success, decreases number of attempts, decreases average time to the return of blood and reduces mechanical complications rate.

The Effectiveness of Real-Time Ultrasound-Guided Central Venous Catheterization: A Comparison with the Landmark Technique in Jordanian Patients

“…The incidence of carotid puncture in the US group is significantly lower than the LM group, confirming the results of previous studies (Denys et al, 1993;Karakitsos et al, 2006). Sazdov et al (2017) reported a 14.5% complication rate in the landmark guided techniques versus a 4% rate when using ultrasound (Sazdov et al, 2017). Other studies have reported similar significantly lower complication rates in the ultrasound guided method (Froehlich et al, 2009;Lamperti et al, 2012;Turker et al, 2009).…”

“…These results are consistent with the findings of Turker et al study (Turker et al, 2009). However, other studies have demonstrated an increased rate of successful catheterizations in the US group when compared with the LM group (Karakitsos et al, 2006;Sazdov et al, 2017;Serafimidis et al, 2009). This contradictory between our results and otherscould be attributed to the fact that at JUH usually trained senior residents insert central venous catheters, reducing failure rates.…”

Vena-subclavia-Katheter und Pneumothoraxrisiko

“…Zu dieser Zeit waren die zur Verfügung stehenden Ultraschallgeräte weit weniger geeignet als heute. Jüngere Studien zeigen klar, dass die Anwendung der ultraschallgesteuerten Punktion die Komplikationsraten reduzieren und die Erfolgsquoten erhöhen kann [7,8,14,21,25]. Diese Studie soll kein Plädoyer für die landmarkengestützte Technik sein.…”

Therapeutic strategy of central vein perforation accompanied by a mediastinal lesion after catheterization

“…The incidence of complications based on experience and body surface markings can increase to 14.5%. 2 Pneumothorax and a misplaced catheter are the most common insertion complications. Other rare complications include carotid artery pseudoaneurysm, 3 thyroid neck stem injury, and puncture injury to the phrenic nerve 4 causing chylothorax 5 and pericardial tamponade.…”