Abstract:
Central venous catheterisation is a technically challenging procedure with numerous indications, including fluid resuscitation, total parenteral nutrition, chemotherapy or central venous pressure monitoring. There has been recent debate regarding the optimal technique for guidewire placement; a thin-walled introducer needle (TWN) or a catheter-over-needle (CON) technique, with the latter being suggested by the American Society of Anaesthesiologists as providing more stable access if manometry is used for venous confirmation [ 1 ]. Despite investigation through multiple randomised controlled trials, there has been conflicting results, and thus neither method has shown clear superiority [ 2 , 3 , 4 , 5 ]. This review sets out to compare rates of success, complications and procedure time for the TWN vs CON techniques for patients requiring central venous access.
Reference:
Fairley L. Thin-walled introducer needle vs catheter-over-needle technique for central venous catheterisation: A brief meta-analysis [published online ahead of print, 2020 Aug 15]. Am J Emerg Med. 2020;S0735-6757(20)30716-6. doi:10.1016/j.ajem.2020.08.030