Complications in internal jugular vs subclavian ultrasound-guided central venous catheterization: a comparative randomized trial

Shin, Hyung-Jin; Na, Hyo‐Seok; Koh, Won Uk; Ro, Young Jin; Lee, Jung Man; Choi, Yoon-Dong; Park, Seongjoo; Kim, Jinhee

doi:10.1007/s00134-019-05651-9

Cited by 53 publications

(70 citation statements)

References 33 publications

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“…Other ultrasound-guided approaches, including the subclavian vein (SCV), axillary vein and femoral vein, are also increasingly supported by evidence. Shin et al demonstrated a very low complication rates for both IJV and SCV ultrasound-guided catheterization [16]. This new study demonstrated that catheterization of both veins is safe when guided by ultrasound, without superiority of the subclavian approach.…”

Section: Procedural Guidancementioning

confidence: 73%

Focus on ultrasound in intensive care

2020

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Over the past two decades, the amount of literature on point of care ultrasound (PoCUS) has been increasing rapidly. Nowadays, a growing body of evidence strongly supports its role in several fields with particular interest to the acute care settings. This article will review some recent literature that may be of interest to the critical care community. Our literature review mainly focuses on thoracic PoCUS, including eight articles on lung ultrasound (LUS), six articles on echocardiography and one article on diaphragm ultrasound. We also cite an important review on brain ultrasound, one article on multiorgan PoCUS and two articles on procedure guidance.

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Section: Procedural Guidancementioning

confidence: 73%

Focus on ultrasound in intensive care

2020

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“…Moreover, all patients reported better scores [15]. Furthermore, we required subclavian central venous catheter insertion to monitor ScVO 2 that has its own risks of several complications including infection, subclavian artery puncture, hemothorax, and pneumothorax [16].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of minimal invasive cardiac output and ScVO₂ monitoring during controlled hypotension for double-jaw surgery

Kim

Song

et al. 2019

J Dent Anesth Pain Med

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Background: Controlled hypotension (CH) provides a better surgical environment and reduces operative time. However, there are some risks related to organ hypoperfusion. The EV1000/FloTrac system can provide continuous cardiac output monitoring without the insertion of pulmonary arterial catheter. The present study investigated the efficacy of this device in double jaw surgery under CH. Methods: We retrospectively reviewed the medical records of patients who underwent double jaw surgery between 2010 and 2015. Patients were administered conventional general anesthesia with desflurane; CH was performed with remifentanil infusion and monitored with an invasive radial arterial pressure monitor or the EV1000/FloTrac system. We allocated the patients into two groups, namely an A-line group and an EV1000 group, according to the monitoring methods used, and the study variables were compared. Results: Eighty-five patients were reviewed. The A-line group reported a higher number of failed CH (P = 0.005). A significant correlation was found between preoperative hemoglobin and intraoperative packed red blood cell transfusion (r = 0.525; P < 0.001). In the EV1000 group, the mean arterial pressure (MAP) was significantly lower 2 h after CH (P = 0.014), and the cardiac index significantly decreased 1 h after CH (P = 0.001) and 2 h after CH (P = 0.007). Moreover, venous oxygen saturation (ScVO2) decreased significantly at both 1 h (P = 0.002) and 2 h after CH (P = 0.029); however, these values were within normal limits. Conclusion: The EV1000 group reported a lower failure rate of CH than the A-line group. However, EV1000/FloTrac monitoring did not present with any specific advantage over the conventional arterial line monitoring when CH was performed with the same protocol and same mean blood pressure. Preoperative anemia treatment will be helpful to decrease intraoperative transfusion. Furthermore, ScVO2 monitoring did not present with sufficient benefits over the risk and cost.

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“…All the included studies recorded arterial injury complication, probably because it's one of the most common instant mechanical complications both in traditional landmark cannulation and the ultrasound assisted cannulation 2,24 . The seven studies together created a moderate heterogeneity (I 2 =70.2%), but no signi cant statistical difference was detected between the two insertion sites in the quantitative analysis (RR=1.137, 95% CI: 0.541-2.387, p=0.735, Figure 2).…”

Section: Arterial Injurymentioning

confidence: 99%

Central Venous Catheterization (CVC) Site Choice Based on Anatomical Landmark Technique: A Systematic Review and Meta-analysis Short title:CVC Site Choice Strategy

Zhang

et al. 2020

Preprint

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BACKGROUND: Internal jugular vein (IJV) and subclavian vein (SCV) have been the most preferred central venous catheterization (CVC) sites clinically. Based on individual preference and institutional routine, however, the choice of IJV catheterization (IJVC) or SCV catheterization (SCVC) is lack of high-level evidence. We sought to provide useful clinical strategy by comparing the catheterization time, success rate and the mechanical complications involved of the two CVCs.METHODS: We systematically reviewed eligible studies from PubMed, OVID, Cochrane and ClinicalTrials.gov till February 2020. The primary outcomes were catheterization time and overall success rate, and the secondary outcomes were the first-attempt success rate and the instant mechanical complications. RESULTS: A total of 3378 patients from 7 studies were included in the analysis. Neither difference was found on the catheterization time (SMD 95% CI: -0.095-0.124, p=0.792), nor any difference on the overall success rate (RR=1.017, 95% CI: 0.927-1.117, p=0.721, I2=89.6%) between the 2 procedures. However, subgroup analysis showed overall success rate of IJVC was significantly lower than that of SCVC (RR=0.906, 95%CI:0.850-0.965, p=0.002) in adult patients. The first-attempt success rate of IJVC group was higher than SCVC group in the adult patients (RR=1.472, 95%CI:1.004-2.156, p=0.047). No significance was detected in arterial injury (RR=1.137, 95% CI: 0.541-2.387, p=0.735) and pneumothorax (RR=0.600, 95% CI: 0.32-1.126, p=0.112) between the two procedures. Hematoma was significantly more in IJVC group than that in SCVC group (RR=2.824, 95% CI: 1.181-6.751, p=0.02). CONCLUSIONS: Compared with IJVC, SCVC has a higher overall success rate while a lower first-attempt success rate in adults, and has involved with less hematoma. However, more high-quality studies are essential to provide better evidence especially in pediatric patients. TRIAL REGISTRATION: This meta-analysis was pre-registered in PROSPERO (CRD42020165444).

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Complications in internal jugular vs subclavian ultrasound-guided central venous catheterization: a comparative randomized trial

Cited by 53 publications

References 33 publications

Focus on ultrasound in intensive care

Focus on ultrasound in intensive care

Efficacy of minimal invasive cardiac output and ScVO₂ monitoring during controlled hypotension for double-jaw surgery

Central Venous Catheterization (CVC) Site Choice Based on Anatomical Landmark Technique: A Systematic Review and Meta-analysis Short title:CVC Site Choice Strategy

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Complications in internal jugular vs subclavian ultrasound-guided central venous catheterization: a comparative randomized trial

Cited by 53 publications

References 33 publications

Focus on ultrasound in intensive care

Focus on ultrasound in intensive care

Efficacy of minimal invasive cardiac output and ScVO2 monitoring during controlled hypotension for double-jaw surgery

Central Venous Catheterization (CVC) Site Choice Based on Anatomical Landmark Technique: A Systematic Review and Meta-analysis Short title:CVC Site Choice Strategy

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Efficacy of minimal invasive cardiac output and ScVO₂ monitoring during controlled hypotension for double-jaw surgery