Eliminating Arterial Injury During Central Venous Catheterization Using Manometry

Ezaru, Catalin S.; Mangione, Michael P.; Oravitz, Todd M.; Ibinson, James W.; Bjerke, Richard J.

doi:10.1213/ane.0b013e31818f87e9

Cited by 89 publications

(67 citation statements)

References 10 publications

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“…Typically, when size of the IJV and its relation to the carotid artery can complicate cannulation when using the anatomic landmark approach. In fact, several reports have described an approximate 5% rate of unintended cervical artery puncture with the landmark-based technique [13,18].…”

Section: Ultrasound-guided Technique For Placement Of Ijv Cvcs Using mentioning

confidence: 99%

“…Given this risk, the use of manometry (i.e., tubing connected to the needle to demonstrate low pressure in the resulting blood column and easy flow of blood back into the vessel) and ultrasound have been reported to decrease the percentage of IJV cannulation complications [13,19,20]. Manometry, however, does not decrease overall arterial puncture, as approximately 5% of the cases reported by Ezaru et al involved puncture of the artery with the finder needle [13].…”

Section: Ultrasound-guided Technique For Placement Of Ijv Cvcs Using mentioning

confidence: 99%

“…Overall, more than 15% of patients who undergo central venous catheterization experience a complication [1,[7][8][9][10][11][12]. In light of this statistic, there is ongoing debate concerning the best method of needle confirmation and wire placement within the vessel [13]. This brief report reviews the various techniques for CVC placement via the IJV.…”

Section: Introductionmentioning

confidence: 99%

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Long-axis view for ultrasound-guided central venous catheter placement via the internal jugular vein

McEvoy

Gravenstein

2016

Rom J Anaesth Int Care

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Background. In modern practice, real-time ultrasound guidance is commonly employed for the placement of internal jugular vein catheters. With a new tool, such as ultrasound, comes the opportunity to refine and further optimize the ultrasound view during jugular vein catheterization. We describe jugular vein access techniques and use the long-axis view as an alternative to the commonly employed short-axis cross-section view for internal jugular vein access and cannulation.Conclusion. The long-axis ultrasound-guided internal jugular vein approach for internal jugular vein cannulation is a useful alternative technique that can provide better needle tip and guidewire visualization than the more traditional short-axis ultrasound view.

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Section: Ultrasound-guided Technique For Placement Of Ijv Cvcs Using mentioning

confidence: 99%

Section: Ultrasound-guided Technique For Placement Of Ijv Cvcs Using mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-axis view for ultrasound-guided central venous catheter placement via the internal jugular vein

McEvoy

Gravenstein

2016

Rom J Anaesth Int Care

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“…The Society of Cardiovascular Anesthesiologists (SCA) considered the ultrasound-guided central venous puncture as the technique of choice, with a classification of "1A" (2). According to a study performed by SCA, 67% of the anesthesiologists did not use ultrasound and only 15% used ultrasound as a routine (3). Many investigations have reported that the high level of success in IJV catheterization on one hand and decreased arterial puncture and other complications (hematoma, hemothorax, and pneumothorax) on the other hand are due to utilization of ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Comparison of US-Guided Catheterization of the Right Internal Jugular Vein Using Medial-Oblique and Short Axis Techniques

Kamalipour¹,

Shahbazi²,

Derakhshan³

et al. 2015

Int Cardiovasc Res J

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A B S T R A C TBackground: Although some investigations have shown higher rates of successful first attempt and fewer attempts by using ultrasound-guided Internal Jugular Vein (IJV) catheterization, arterial puncture is still common. Objectives: The present study aimed to investigate US-guided catheterization of the right IJV via medial-oblique technique and also compare this technique to short-axis technique in open-heart surgery patients. Patients and Methods: In this randomized clinical trial, 80 patients referred to cardiac operating room of Namazi hospital, Shiraz, Iran from March to July 2014 were selected using census method. Block randomization with website was also done. Then, the patients were divided into two groups of 40, Short Axis Group (SAG) and Medial-Oblique Group (M-OG). For short-axis technique, patient's head was positioned at zero degree angulation with his trunk. For medial-oblique technique, on the other hand, patient's head was tilted to left to 45 degrees between the head and trunk. Sex, age, Body Mass Index (BMI), access time, guidewire time, cannulation time, total attempts for catheterization, first, second, and third attempt success, arterial puncture, hematoma, bleeding, and catheter malposition were recorded. The overlap between the carotid artery and IJV in zero-and 45-degree angulation was estimated through ultrasound print. After all, Kolmogorov-Smirnov test was used to assess normal distribution of the data. Then, the data were analyzed through Student's t-test, Mann-Whitney U test, and chi-square test. P < 0.05 was considered as statistically significant. Results:The results showed no significant differences between the two groups regarding the duration of different catheterization steps (P = 0.376). In all the cases in both groups, accessing the vein was successful with three attempts or less. There were no clinical complications of catheterization in the two groups. The mean of overlap was 23.60 ± 33.47 in zero-degree angulation between the head and trunk and 32.72 ± 36.38 in 45-degree angulation and this difference was statistically significant (P = 0.001). Conclusions:The results of the present study showed that both US-guided techniques under investigation had the same duration in different catheterization steps, total success rate, and primary mechanical complications, and could be used in clinics.

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“…Some of these complications may sometimes become more severe than the primary disease itself. The complications related to procedure are pneumothorax, hemothorax, air embolism, arterial puncture, arrhythmia, pericardial tamponade and brachial plexus injury [4][5][6] .The short term complications after the procedure include hemoptysis, hematoma in the port implantation site, dehiscence of the incision 7,8 ; whereas late complications include catheter related infections, thrombosis of the catheter, tear and transection of the catheter, 'pinch-off' syndrome, relocation of the catheter tip, embolization due to catheter, extravasations of the given medications, slipping of the catheter, erosion and/or perforation of superior vena cava [9][10][11][12][13][14] . However, these short and late complications may be observed in both terms.…”

mentioning

confidence: 99%

Evaluation of the removal reasons of totally implantable venous devices in children: a retrospective study

Kılıç¹,

Soyer²,

Karnak³

et al. 2016

Turk J Pediatr

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Totally implantable venous access devices (TIVADs) increase the quality of life in children with hematologic and oncologic diseases or organ failures. The aim of this study is to determine the reasons for port removal. The port catheters, implanted and removed in patients between January 2000 and June 2013 were evaluated retrospectively. The patients were divided into two groups, whose port catheters were removed due to completed therapy (completed therapy group, CTG) and whose port catheters were removed because of a port catheter-related complications (complication group, CG). In the CG, the patients whose port catheters are removed for infectious reasons are investigated for whether there is a relationship with age, gender, body mass index (BMI), height and weight at the time of port implantation and removal. In total, 242 patients who underwent port implantation and removal were included in the study. The male to female ratio was 1.32/1 and the mean age of the patients was 9.4±4.9 years (0-24 year). Patients were enrolled in CTG (n=170, 70.2%), and CG (n=72, 29%). There is a positive correlation between BMI and infections (p<0.05). In the CG, patients under steroid treatment had higher incidence of non-infectious causes than infectious causes (p<0.05). Oppositely, non infectious complications were higher in steroid free patients (p<0.05). There was no catheter related mortality in the entire study group.The hematological malignancies and solid tumors are the most common underlying primary disease in patients with port removal because of complications. Infectious complications are most common cause of port removal in children and despite other microorganism, fungi should be considered as a cause of catheter related infections.

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Eliminating Arterial Injury During Central Venous Catheterization Using Manometry

Abstract: Consistent use of manometry, to verify venous placement, during central venous catheterization effectively eliminated arterial injury from unintended arterial cannulation during the 15-yr assessment.

Cited by 89 publications

References 10 publications

Long-axis view for ultrasound-guided central venous catheter placement via the internal jugular vein

Long-axis view for ultrasound-guided central venous catheter placement via the internal jugular vein

Comparison of US-Guided Catheterization of the Right Internal Jugular Vein Using Medial-Oblique and Short Axis Techniques

Evaluation of the removal reasons of totally implantable venous devices in children: a retrospective study

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