A quantitative analysis of the relation between the clavicular tilt angle and subclavian central venous catheter misplacement

Jeong, Hoe-Hwan; Yoon, Jung‐Hoon; Oh, Sungho; Won, Je Hwan; Min, Young-Gi; Gravenstein, Nikolaus; Choi, Sang Hyun

doi:10.15441/ceem.14.003

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…Thrombosis of internal jugular vein, elevated intracranial pressure, retrograde perfusion of the intracranial veins and infection are other complications which may occur. 13,14…”

Section: Discussionmentioning

confidence: 99%

Influence of arm position during infraclavicular subclavian vein catheterization in coronary artery bypass graft surgery

Tarbiat

Davoudi

Salimbahrami

2018

J Cardiovasc Thorac Res

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Introduction: Percutaneous subclavian vein catheterization via infraclavicular approach is one of the most widely used cannulation techniques for inserting catheters into a central vein. The aim of this study was to evaluate influence of arm position during infraclavicular subclavian vein catheterization with landmark-based technique in coronary artery bypass graft (CABG) surgery. Methods: Between September 2017 and June 2018, this prospective randomized clinical trial was performed in 320 patients. The patients were randomly assigned to the Neutral group (the arms kept by the side) or Abduction group (the arm was abducted to 90°). The success and complication rates were compared in the two groups. The data were analyzed using SPSS software. Results: In the first attempt of subclavian vein cannulation, the success rate had no significant difference between the two groups (P = 0.185). In the second attempt of catheterization, the success rate in Abduction group (40.5%) was lower than Neutral group (81.2%). The overall success rate in two attempts were (84.4%) in the Abduction group and (96.2%) in the Neutral group. There was a significant difference between two groups in the second and overall success rates (P = 0.0001). In 34 (10.6%) patients, subclavian artery puncture occurred, 30 (18.8%) in the Abduction group and 4 (2.5%) in the Neutral group. There was a significant difference between two groups (P = 0.0001). Pneumothorax was occurred in 15 (9.4%) in the Abduction group and 3 (1.9%) in the Neutral group. There was also a significant difference between two groups (P = 0.004). The differences in other complications on two groups were statistically insignificant. Conclusion: Compared with Abduction group, the Neutral group resulted in higher success rate and fewer subclavian artery puncture and pneumothorax. The incidences of other complications were similar on both groups.

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“…Thrombosis of internal jugular vein, elevated intracranial pressure, retrograde perfusion of the intracranial veins and infection are other complications which may occur. 13,14…”

Section: Discussionmentioning

confidence: 99%

Influence of arm position during infraclavicular subclavian vein catheterization in coronary artery bypass graft surgery

Tarbiat

Davoudi

Salimbahrami

2018

J Cardiovasc Thorac Res

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“…Internal jugular vein catheterization (IJC) is useful in emergency departments (ED) for monitoring hemodynamic status and for infusion of fluid or nutrients. As compared to subclavian vein catheterization, IJC has fewer complications such as pneumothorax or hemothorax, and thus is more often recommended [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of internal jugular vein dilation between Valsalva maneuver and proximal internal jugular vein compression

2016

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ObjectiveThe Valsalva maneuver is recognized as an effective method to dilate the internal jugular vein (IJV). However, this maneuver cannot be performed in many cases, such as children and unconscious patients. The aim of this study was to evaluate the effectiveness of proximal IJV compression, which can easily be performed, regardless of patient cooperation.MethodsHealthy adult volunteers were recruited from tertiary hospital employees. Basic anatomic and physiologic data were collected. The subjects lay down as if they were undergoing IJV catheter insertion, in the supine position with their necks turned 30 degrees to the left. The main outcome was the cross-sectional area (CSA) of the distal IJV as measured by ultrasound in four stages. The first stage was sham without any maneuver. The second was Valsalva maneuver, the third was digital IJV compression, and the fourth was digital compression accompanied by simultaneous Valsalva maneuver.ResultsA total of 41 volunteers were enrolled. Twenty-six (63.41%) were male with an average age of 28.15±2.85 years. Mean height was 170.74±8.66 cm and mean neck circumference was 35.28±3.87 cm. The mean CSA-IJV was 1.06±0.36 cm2 without any maneuver. It increased to 1.34±0.45 cm2 with Valsalva maneuver (P<0.001), to 1.26±0.41 cm2 with digital compression (P<0.001), and to 1.41±0.47 cm2 with the two maneuvers combined (P=0.01).ConclusionDigital proximal IJV compression effectively dilates the distal IJV. When performed simultaneously with the Valsalva maneuver, the effect was enhanced.

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A quantitative analysis of the relation between the clavicular tilt angle and subclavian central venous catheter misplacement

Cited by 2 publications

References 26 publications

Influence of arm position during infraclavicular subclavian vein catheterization in coronary artery bypass graft surgery

Influence of arm position during infraclavicular subclavian vein catheterization in coronary artery bypass graft surgery

Comparison of internal jugular vein dilation between Valsalva maneuver and proximal internal jugular vein compression

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