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"Although not superior to the standard internal jugular approach, the novel supraclavicular approach proved to be a noninferior method for central venous cannulation" Aydın et al (2021).

Ultrasound-guided CVC placement

Abstract:

Objectives: To assess the superiority of a novel ultrasound-guided central venous catheterization technique, supraclavicular brachiocephalic catheterization, compared to jugular vein catheterization.

Design: Prospective randomized trial.

Setting: Operating rooms and intensive care unit.

Participants: Eighty-six patients with central catheter placement were included in the present study.

Interventions: In the brachiocephalic group, ultrasound-guided catheterization of the brachiocephalic vein was performed via the supraclavicular route using needle-in-plane and syringe-free techniques. In the jugular group, ultrasound-guided catheterization of the internal jugular vein was performed using the needle-out-of-plane technique.

Measurements and main results: Measurements included number of needle insertion attempts, ultrasonography times, and cannulation times. Additionally, ultrasound visibility of the veins, needle, guidewire, and catheter, as well as ease of the procedure, were assessed. Mean cannulation time was 27.65 ± 25.36 seconds in Group B and 28.16 ± 21.72 seconds in Group J. The overall success rate was 97.6% in Group B and 97.7% in Group J. The mean ease score of the cannulation procedure was 8.78 ± 1.13 in Group B and 8.67 ± 1.23 in Group J. No significant differences were detected between groups. The mean ultrasonography time was 11.98 ± 6.91 seconds in Group B and 2.88 ± 1.47 seconds in Group J. Ultrasound visibility of the brachiocephalic, jugular, and subclavian veins, as well as the needle and the guidewire, were good; however, visibility of the catheter was poor.

Conclusions: Although not superior to the standard internal jugular approach, the novel supraclavicular approach proved to be a noninferior method for central venous cannulation.

Reference:

Aydın T, Balaban O, Turgut M, Tokur ME, Musmul A. A Novel Method for Ultrasound-Guided Central Catheter Placement-Supraclavicular Brachiocephalic Vein Catheterization Versus Jugular Catheterization: A Prospective Randomized Study. J Cardiothorac Vasc Anesth. 2021 Jun 12:S1053-0770(21)00482-1. doi: 10.1053/j.jvca.2021.06.010. Epub ahead of print. PMID: 34247928.