Comparison of the bedside central venous catheter placement techniques: landmark vs electrocardiogram guidance

Lee, J.-H.; Bahk, Jae Hyon; Ryu, Ho Geol; Jung, Chul Woo; Jeon, Yong Sun

doi:10.1093/bja/aep046

Cited by 58 publications

(50 citation statements)

References 19 publications

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“…[3161718] CXR on the other hand is less accurate (parallax error is greater and more variable in a portable CXR - anteroposterior view) but offer a cheap and least sophisticated imaging technique to assess a CVC tip in relation to the carina, which is well accepted as a bedside reliable and cost-effective tool. [111819] These two techniques are feasible in all major hospitals. Ultrasound-guided venous puncture and fluoroscopy/C-arm-guided CVC tip placement showed a technical success rate of 98%,[20] but they are not feasible for all major hospitals.…”

Section: Discussionmentioning

confidence: 99%

Role of chest X-ray in citing central venous catheter tip: A few case reports with a brief review of the literature

Venugopal

Koshy

2013

J Anaesthesiol Clin Pharmacol

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Central venous catheter (CVC) insertions are increasingly performed in surgical patients and intensive therapy. A simple and invasive procedure performed under strict sterile precautions with complications ranging from arrhythmias; infections; and life-threatening complications such as pericardial tamponade, cardiac perforation and even death. A post-procedure chest X-ray (CXR), though does not accurately assess the tip of the catheter in relation to the superior vena cava (SVC) and right atrium (RA), can detect malpositions, safety of catheter tip, pneumothorax and kinking. We would like to share some of the malpositions we encountered in our centre, their management and a brief review of the literature on optimal catheter tip location.

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Section: Discussionmentioning

confidence: 99%

Role of chest X-ray in citing central venous catheter tip: A few case reports with a brief review of the literature

Venugopal

Koshy

2013

J Anaesthesiol Clin Pharmacol

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“…The use of anatomic landmarks is not a sufficiently reliable method for preventing misplacement of a CVC [54,55]. In patients with sinus rhythm, the use of endocavitary EKG during catheter insertion has been shown to predict the correct placement of CVCs inserted via the right internal jugular or right subclavian vein.…”

Section: Diagnosing Complications Of Central Venous Catheterizationmentioning

confidence: 99%

Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications

et al. 2013

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Vascular access used in the treatment of patients involves central and peripheral vein accesses and arterial accesses. Catheterization of central veins is widely used in clinical practice; it is a necessary part of the treatment of patients in various settings. The most commonly involved vessels are the internal jugular, subclavian, and femoral veins. The mechanical, infectious, and thrombotic complications of central venous catheterization are markedly reduced when the procedure is performed with real-time ultrasound guidance or (to a slightly lesser extent) ultrasound assistance. Ultrasound guidance is also used to create peripheral venous accesses, for catheterization of peripheral veins and for peripheral insertion of central venous catheters. In this setting, it increases the catheterization success rate, especially during difficult procedures (e.g., obese patients, children) and reduces complications such as catheter-related infections and venous thrombosis. Arterial cannulation is used for invasive monitoring of arterial pressure and for access during diagnostic or therapeutic procedures. Ultrasound guidance reduces the risk of catheterization failure and complications. It is especially useful for arterial catheterization procedures performed in the absence of a palpable pulse (e.g., patient in shock, ECMO). Imaging support is being used increasingly to facilitate the creation of vascular accesses under difficult conditions, in part because of the growing use of ultrasonography as a bedside procedure. In clinical settings where patients are becoming increasingly vulnerable as a result of advanced age and/or complex disease, the possibility to reduce the risks associated with these invasive procedures should motivate clinicians to acquire the technical skills needed for routine use of sonographic support during vascular access procedures. Keywords Vascular access Á UltrasoundRiassunto Gli accessi vascolari utilizzati nella cura dei pazienti comprendono gli accessi venosi centrali e periferici e gli accessi arteriosi. L'incannulamento di accessi venosi centrali è manovra largamente diffusa nella pratica clinica e si rende necessaria per la cura dei pazienti in molteplici contesti. I vasi centrali che usualmente vengono incannulati sono la vena giugulare interna, la vena succlavia e la vena femorale. Nell'incannulamento venoso centrale sia l'eco-assistenza che l'eco-guida real time, pur con una leggera superiorità di quest'ultima, riducono drasticamente le complicanze meccaniche, infettive e trombotiche. La guida ecografica viene utilizzata anche per l'accesso venoso periferico, per l'incannulamento di vasi periferici e di vasi centrali a inserzione periferica (PICC). In questo contesto la guida ecografica aumenta il successo della manovra di incannulamento soprattutto in condizioni di difficoltà, come avviene nei pazienti obesi o nei bambini, e diminuisce le complicanze quali le infezioni catetere correlate e le trombosi venose. L'incannulamento arterioso viene utilizzato per il monitoraggio cruent...

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“…(4) In a prospective randomized study by Ezri T et al on 100 patients, for the comparison of CVC insertion by topographic landmark technique and predetermined length (15 cm) insertion, 98% of patients in landmark technique were found to have catheter tip positioned at right place on chest Xray. In this the author did not use TEE to check the position of catheter tip as in our study (5) Lee JH et al compared the accuracy of CVC tip localization between ECG-and landmark-guided catheterization and concluded that central venous catheterization via the right IJV, landmark guidance was comparable with ECG guidance with regard to CVC tip positioning in the superior vena cava (6) In a study by Myung-Chun Kim et al to determine whether the topographical measurement along the course of the central veins can estimate the approximate insertion depths of central venous catheters (CVC). The CVC locations could be predicted with a margin of error between 2.2 cm below the carina and 2.3 cm above the carina in 95% of patients (7) The above studies have done the IJV cannulation using different landmark techniques.…”

Section: Resultsmentioning

confidence: 83%

Bedside Prediction of Correct Length of Right Internal Jugular Venous Catheters Based on Anatomical Land Marks

Vs¹

2017

JMSCR

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Comparison of the bedside central venous catheter placement techniques: landmark vs electrocardiogram guidance

Abstract: During central venous catheterization via the right IJV, landmark guidance was comparable with ECG guidance with regard to CVC tip positioning in the superior vena cava.

Cited by 58 publications

References 19 publications

Role of chest X-ray in citing central venous catheter tip: A few case reports with a brief review of the literature

Role of chest X-ray in citing central venous catheter tip: A few case reports with a brief review of the literature

Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications

Bedside Prediction of Correct Length of Right Internal Jugular Venous Catheters Based on Anatomical Land Marks

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