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Central venous catheterisation techniques

D Rivera-Tocancipá, E Díaz-Sánchez, C A Montalvo-Arce
INTRODUCTION: The insertion of a central venous line in children and adolescents is technically more difficult, due to the smaller size of the structures. This can lead to an increase in immediate complications, which can be reduced when using ultrasound. In our institution, the percentage of these complications and the use of ultrasound are unknown. OBJECTIVE: To describe the frequency of immediate complications of central venous catheterisation guided by the ultrasound in a general university hospital, compared to the anatomical landmarks technique in children less than 18years of age...
April 4, 2018: Revista Española de Anestesiología y Reanimación
Oliver G B Dixon, George E Smith, Daniel Carradice, Ian C Chetter
INTRODUCTION: Central venous catheterisation (CVC) is a technique commonly used to obtain vascular access and over five million CVCs are inserted annually. This systematic review of CVC-related arterial injury aims to compare outcomes reported with different management strategies. METHODS: PRISMA guidelines were followed. A search of Medline, Embase, Central and CINAHL was performed. Results were limited to papers in humans and in English with duplicates removed...
March 21, 2017: Journal of Vascular Access
Tejesh C Anandaswamy, Vinay Marulasiddappa
BACKGROUND AND AIMS: Subclavian central venous catheterisation (CVC) is employed in critically ill patients requiring long-term central venous access. There is no gold standard for estimating their depth of insertion. In this study, we compared the landmark topographic method with the formula technique for estimating depth of insertion of right subclavian CVCs. METHODS: Two hundred and sixty patients admitted to Intensive Care Unit requiring subclavian CVC were randomly assigned to either topographic method or formula method (130 in each group)...
July 2016: Indian Journal of Anaesthesia
Neeraj Kumar Barnwal, Sona T Dave, Raylene Dias
BACKGROUND AND AIMS: The complications of central venous catheterisation can be minimized by ensuring catheter tip placement just above the superior vena cava-right atrium junction. We aimed to compare two methods, using an electrocardiogram (ECG) or landmark as guides, for assessing correct depth of central venous catheter (CVC) placement. METHODS: In a prospective randomised study of sixty patients of <12 years of age, thirty patients each were allotted randomly to two groups (ECG and landmark)...
July 2016: Indian Journal of Anaesthesia
E Kim, B G Kim, Y J Lim, Y T Jeon, J W Hwang, H C Kim, Y H Choi, H P Park
In clinical practice, both a thin-walled introducer needle and catheter-over-needle technique can be used to allow insertion of a guidewire during central venous catheterisation using the Seldinger technique. We compared the incidence of catheterisation-related complications (arterial puncture, haemothorax, pneumothorax, haematoma and catheter tip malposition) and insertion success rate for these two techniques in patients requiring right-sided subclavian central venous catheterisation. A total of 414 patients requiring infraclavicular subclavian venous catheterisation were randomly allocated to either a thin-walled introducer needle (needle group, n = 208) or catheter-over-needle technique (catheter group, n = 206)...
September 2016: Anaesthesia
T Maecken, L Heite, B Wolf, P K Zahn, R J Litz
The objective of this prospective, randomised study was to examine the impact of a multi-angle needle guide for ultrasound-guided, in-plane, central venous catheter placement in the subclavian vein. One hundred and sixty patients were randomly allocated to two groups, freehand or needle-guided, and then 159 catheterisations were analysed. Cannulation of the first examined access site was successful in 96.9% of cases with no significant difference between groups. There were three arterial punctures and no other severe injuries...
November 2015: Anaesthesia
A Shah, A Smith, S Panchatsharam
Central venous catheterisation is a commonly performed procedure in anaesthesia, critical care, acute and emergency medicine. Traditionally, subclavian venous catheterisation has been performed using the landmark technique and because of the complications associated with this technique, it is not commonly performed in the United Kingdom - where the accepted practice is ultrasound-guided internal jugular vein catheterisation. Subclavian vein catheterisation offers particular advantages over the internal jugular and femoral vein sites such as reduced rates of line-related sepsis, improved patient comfort and swifter access in trauma situations where the internal jugular vein may not be easily accessible...
August 2013: International Journal of Clinical Practice
Mariasanta Napolitano, Alessandra Malato, Francesco Raffaele, Manuela Palazzolo, Giorgio Lo Iacono, Roberto Pinna, Girolamo Geraci, Giuseppe Modica, Giorgia Saccullo, Sergio Siragusa, Massimo Cajozzo
BACKGROUND: Cannulation of the internal jugular vein (CVC) is a blind surface landmark-guided technique that could be potentially dangerous in patients with very low platelet counts. In such patients, ultrasonography (US)-guided CVC may be a valid approach. There is a lack of published data on the efficacy and safety of urgent US-guided CVC performed in haematological patients with severe thrombocytopenia. MATERIALS AND METHODS: We retrospectively studied the safety of urgent CVC procedures in haematological patients including those with severe thrombocytopenia (platelet count <30×10(9)/L)...
October 2013: Blood Transfusion, Trasfusione del Sangue
Ann O'Connor, Ann M Hanly, Eamonn Francis, Noreen Keane, Deborah A McNamara
BACKGROUND: Data was prospectively collected on 850 consecutive patients undergoing central venous catheterisation (CVC) to receive total parenteral nutrition (TPN) in a major university teaching hospital over a 46 months period. METHODS: Data included information about CVC insertion and clinical outcomes, most notably, suspected catheter-related blood stream infections (CRBSI). RESULTS: The internal jugular vein was the most common site (n = 882, 68%), followed by the subclavian vein (n = 344, 24...
February 2013: Journal of Clinical Medicine Research
Thanaporn Lorchirachoonkul, Lian Kah Ti, Shivani Manohara, Soh Teng Lye, Sue-Anne Tan, Liang Shen, Dave Song Chua Kang
INTRODUCTION: Complications occur in over 15% of central venous cannulations, often a result of anatomical variations. This study aimed to determine the anatomical variations of the internal jugular vein (IJV), demonstrate the likely success of cannulation and assess the risk of carotid artery (CA) injury when catheterising the IJV using the external landmarks technique at various degrees of head rotation in the local population. METHODS: 100 elective cardiac surgical patients were prospectively enrolled...
May 2012: Singapore Medical Journal
M J Corrales-Fernández, M T Gea-Velázquez de Castro, R Limón-Ramírez, J J Miralles-Bueno, J Requena-Puche, J M Aranaz-Andrés
OBJECTIVE: To determine the patient and medical care characteristics of Health Care-Associated Infections (HCAI) and to determine whether or not there are any differences between those that may be avoidable. METHOD: A retrospective cohort study, based on three Spanish cohort studies of Adverse Events associated with hospitalization. The medical records were reviewed to assess whether or not the health care was the causing factor of the HCAI. We carried out the analyses using the same methodology as the National Study on the Adverse Effects associated with hospitalization (ENEAS)...
November 2011: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
C H K Dix, D T O Yeung, M L Rule, D D F Ma
AIMS: Central venous catheters (CVC) are integral to modern haematology practice; however, they are associated with a range of complications. This prospective study aimed to determine the rate of CVC-related complications and risk factors in haematology patients, who are vulnerable because of their underlying pathology and treatments. METHODS: All inpatients that had a non-tunnelled CVC inserted in a 14-month period in the haematology ward at St Vincent's Hospital were enrolled...
August 2012: Internal Medicine Journal
Il-Seok Kim, Sang-Soo Kang, Joon-Hee Park, Sung-Jun Hong, Keun-Man Shin, Young-Joon Yoon, Myoung-Sun Kim
BACKGROUND AND OBJECTIVE: The axillary vein is another option for central venous catheterisation, with less chance of accidental arterial puncture as there is a greater distance between artery and vein, and from vein to rib cage, compared with other sites. Better success, lower complication rates and faster access can be achieved with ultrasound guidance which is becoming the established technique for central venous catheterisation. We measured two key factors for successful infraclavicular axillary venous catheterisation: depth and diameter of the infraclavicular axillary vein in its medial part using ultrasound...
May 2011: European Journal of Anaesthesiology
Tomohiro Nakata, Yoshifumi Fujimoto, Keiichi Hirose, Masaki Osaki, Yuko Tosaka, Yujiro Ide, Maiko Tachi, Kisaburo Sakamoto
OBJECTIVE: Fontan completion in patients with atrial isomerism, in which the inferior vena cava (IVC) and the hepatic vein (HV) drain separately, is technically challenging. Herein, we review our surgical approach to these patients. METHODS: The medical records of 50 consecutive patients with atrial isomerism who underwent Fontan completion between 1998 and 2008 were reviewed retrospectively. RESULTS: Separate HV drainage was present in 17 patients...
June 2010: European Journal of Cardio-thoracic Surgery
Ajay Kumar, Alwin Chuan
Central venous catheterisation and arterial catheterisation are common procedures performed by anaesthetists. Traditionally, the technique of locating surface landmarks and palpation was used to assist in vascular access. The introduction of perioperative ultrasonography in the past decade has dramatically changed this procedure. In the United States and United Kingdom, guidelines have recommended the use of ultrasound guidance to reduce complications and improve success in central venous catheterisation. This article summarises the literature on complication rates, efficacy and safety of ultrasound-guided vascular access procedures and describes a practical method of ultrasound-guided central venous access and arterial catheterisation...
September 2009: Best Practice & Research. Clinical Anaesthesiology
A Pikwer, S Acosta, T Kölbel, M Malina, B Sonesson, J Akeson
OBJECTIVE: This study aims to describe the clinical management of inadvertent arterial catheterisation after attempted central venous catheterisation. METHODS: Patients referred for surgical or endovascular management for inadvertent arterial catheterisation during a 5-year period were identified from an endovascular database, providing prospective information on techniques and outcome. The corresponding patient records and radiographic reports were analysed retrospectively...
December 2009: European Journal of Vascular and Endovascular Surgery
E de Jonge
Placement of a central venous catheter is one of the most common invasive procedures and is associated with septic and mechanical complications, such as bleeding and pneumothorax. Up to 30% of attempts to cannulate the central vein fail. Correct positioning of the patient can help to maximise the success rate. For placement of catheters in the subclavian vein, patients should be in the Trendelenburg position without the use of a shoulder roll to retract the shoulders. Traditionally, central venous catheters are placed using a 'blind' technique that relies on external anatomical reference marks to localise the vein...
January 27, 2007: Nederlands Tijdschrift Voor Geneeskunde
S Cipanio, R Oggionio, V Manganio, G Bellandi, L Ercolini, S Michelagnoli
Central venous catheterisation may sometimes be associated with life-threatening complications. Of these, subclavian artery puncture (infraclavicular approach), though seldom, (incidence 1-2%) following accidental arterial cannulation, may lead to arterial occlusion, embolism, pseudoaneurysms, vessel laceration or dissection or fatal hemorrhaging. Such complications may be even more severe in critically ill patients requiring systemic anticoagulation therapy or those with acute coagulation dysfunction. The authors report a case of an accidental cannulation of the subclavian artery with a central catheter and its successful removal using an endovascular cover stent positioned via a percutaneous approach...
April 2007: Minerva Anestesiologica
Dimitrios Karakitsos, Nicolaos Labropoulos, Eric De Groot, Alexandros P Patrianakos, Gregorios Kouraklis, John Poularas, George Samonis, Dimosthenis A Tsoutsos, Manousos M Konstadoulakis, Andreas Karabinis
INTRODUCTION: Central venous cannulation is crucial in the management of the critical care patient. This study was designed to evaluate whether real-time ultrasound-guided cannulation of the internal jugular vein is superior to the standard landmark method. METHODS: In this randomised study, 450 critical care patients who underwent real-time ultrasound-guided cannulation of the internal jugular vein were prospectively compared with 450 critical care patients in whom the landmark technique was used...
2006: Critical Care: the Official Journal of the Critical Care Forum
F A Arogundade, A A Sanusi, T A Badmus, A Ibrahim, A Akinsola
AIMS AND OBJECTIVES: To highlight the indications, problems and prospects of bedside non-surgically inserted jugular and subclavian dual lumen catheters. PATIENTS AND METHODS: Renal failure patients being managed in our centre with indications for central catheterisation were consecutively recruited at presentation. They had bedside non-surgical jugular and subclavian insertion of central catheters using modified Seldinger wire technique and the performance of the catheters monitored...
March 2006: Nigerian Postgraduate Medical Journal
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