Ultrasound-guided technique versus a landmark-guided technique for CVAD placement

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“The purpose of this study was to compare the landmark-guided technique to the ultrasound-guided technique for internal jugular vein cannulation in cardiovascular surgery patients.” Dolu et al (2014).

Reference:

Dolu, H., Goksu, S., Sahin, L., Ozen, O. and Eken, L. (2014) Comparison of an ultrasound-guided technique versus a landmark-guided technique for internal jugular vein cannulation. Journal of Clinical Monitoring and Computing. May 18th. [epub ahead of print].

Abstract:

Central venous cannulation is a commonly preformed procedure in many branches of medicine, particularly in anaesthesia and intensive care medicine. The purpose of this study was to compare the landmark-guided technique to the ultrasound-guided technique for internal jugular vein cannulation in cardiovascular surgery patients. One hundred cardiovascular surgery patients, of whom 65 were male and 35 were female with ages ranging from 22 to 65, who had internal jugular cannulation between December 2010-March 2011 in our clinic were investigated prospectively. Patients were randomized into two groups; ultrasound guided internal jugular cannulation cases in group U (n = 50), and anatomic landmark guided cases in group A (n = 50). The number of attempts until successful catheterization, the time required for successful catheterization, arising complications, the demographics and the duration of catheterization were recorded for each patient. There were no significant differences found in the demographic features between the two groups. The number of attempts for successful catheterization was statistically lower in group U (1.1 ± 0.5) than in group A (2.2 ± 1.6). The time required for successful catheterization was statistically lower in group U (109.4 ± 30.4) than in group A (165.9 ± 91.5). There were no significant differences found in the total complications of the two groups (p = 0.092). Four patients had an arterial punction [group U (n = 0) and group A (n = 4)]and two patients had a hematoma [group U (n = 1) and group A (n = 1)]. Arterial punction complication was increased significantly in landmark group (p = 0.041). The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of attempts.

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