Comparison of Technical Success and Outcome of Tunneled Catheters Inserted via the Jugular and Subclavian Approaches

Macdonald, Sumaira; Watt, Andrew; McNally, Dermot; Edwards, Richard; Moss, Jonathan

doi:10.1016/s1051-0443(07)61470-5

Cited by 75 publications

(51 citation statements)

References 17 publications

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“…This study was comparable to studies mentioned in . [11,10,15,14] In contrast to our study, results of some previous studies reported different complication rates [ Table 4] 5-7. [16,17,13] The potential threats of major pleural and mediastinal complications due to central venous cannulation are self evident.…”

Section: Percutaneous Central Venous Catheterization Bycontrasting

confidence: 98%

“…[10] 2. Comparison of Technical success and outcome by Sumana, Macdonald et al [11] (100% in Internal jugular vein cannulation versus 97% in Subclavian vein cannulation).…”

Section: Resultsmentioning

confidence: 99%

“…In this study, the complication rate in emergency settings could not be commented because the numbers of emergency cannulation are very few compared to elective procedure (6% Vs 94%). [11] 1.83%…”

Section: Percutaneous Central Venous Catheterization Bymentioning

confidence: 99%

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A Comparative Study Of Internal Jugular Vein Cannulation- Central Approach Versus Subclavian Vein Cannulation – Infraclavicular Approach

2016

AIMDR

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Background: Central venous cannulation is a commonly used perioperative procedure to monitor the critically ill patients. The aim of this study is anatomical landmark based cannulation of internal jugular vein and subclavian vein and to determine the outcome, technical ease, complication rate. Though ultrasound guided central venous cannulation may be the gold standard method, it may not be available everywhere. Anaesthesiology residents performed the procedure under the guidance of faculty members in operation theatres based on anatomical land marks. Methods: We prospectively evaluated the performance of central venous cannulation by anaesthesiology residents through either internal jugular vein or subclavian vein based on the anatomical landmark guided techniques. Fifty patients posted for major surgeries were included in the study. Results: The success rate of the procedure, the numbers of attempts, complication rate between both groups are comparable to each other based on the statistical analysis. The time to perform internal jugular vein cannulation is significantly shorter than the time required for subclavian vein cannulation. Conclusion: In places where ultrasound imaging facilities are not available, anatomical land mark based techniques will help us to do the procedure. This study dispels the impression that Internal jugular vein is technically easier with reduced complication rate than subclavian vein cannulation. Results are comparable with each other.

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Section: Percutaneous Central Venous Catheterization Bycontrasting

confidence: 98%

“…[10] 2. Comparison of Technical success and outcome by Sumana, Macdonald et al [11] (100% in Internal jugular vein cannulation versus 97% in Subclavian vein cannulation).…”

Section: Resultsmentioning

confidence: 99%

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A Comparative Study Of Internal Jugular Vein Cannulation- Central Approach Versus Subclavian Vein Cannulation – Infraclavicular Approach

2016

AIMDR

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“…Category IA C. No recommendation can be made for a preferred site of insertion to minimize infection risk for a tunneled CVC [61][62][63]. Unresolved issue D. Place catheters used for hemodialysis and pheresis in a jugular or femoral vein rather than a subclavian vein to avoid venous stenosis if catheter access is needed [259][260][261][262][263]. Category IA IV.…”

Section: Category Ib II Surveillancementioning

confidence: 99%

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

636

843

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These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The These guidelines are intended to provide evidencebased recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

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“…Using the anatomic landmarks, the SV (through an infraclavicular or supraclavicular via), the IJV (with different approaches: e.g., low lateral, high anterior or posterior, and axial among the 2 heads of sternoclavicular muscle), or the FV are the veins generally chosen. Comparison between technical success and outcome of CVADs via "blind" cannulation of IJV and SV demonstrated a decrease in adverse events associated with the insertion for an jugular approach [16] . A retrospective survey of more than 5400 CVAD insertions showed that the low lateral approach to the IJV (the technique of Jernigan) is the easiest and safest method for "blind" cannulation because of the lowest rate of insertion-related adverse events [17] .…”

Section: Site Of Insertionmentioning

confidence: 99%

Focus on peripherally inserted central catheters in critically ill patients

Cotogni

Pittiruti

2014

WJCCM

100

105

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Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings (emergency, intensive care, surgery) and for different purposes (fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device (CVAD) (mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters (PICCs) and centrally inserted central catheters (CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe -due to their placement into peripheral veins of the armand the advantage of a central location of catheter tip suitable for all osmolarity and pH solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as well as the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs (i.e. , low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD (CICCs or PICCs). Second, an inappropriate CVAD choice and, particularly, an inadequate insertion technique are relevant-and often not recognized-potential risk factors for complications in critically ill patients. We strongly believe that all healthcare professionals involved in the choice, insertion or management of CVADs in critically ill patients should know all potential risk factors of complications. This knowledge may minimize complications and guarantee longevity to the CVAD optimizing the risk/benefit ratio of CVAD insertion and use. Proper management of CVADs in critical care saves lines and lives. Much evidence from the medical literature and from the clinical practice supports our belief that, compared to CICCs, the so-called power-injectable peripherally inserted central catheters are a good alternative choice in critical care. 80November 4, 2014|Volume 3|Issue 4| WJCCM|www.wjgnet.com access devices (CVADs) are key elements of management for either adult or pediatric critically ill patients. Healthcare pro...

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Comparison of Technical Success and Outcome of Tunneled Catheters Inserted via the Jugular and Subclavian Approaches

Cited by 75 publications

References 17 publications

A Comparative Study Of Internal Jugular Vein Cannulation- Central Approach Versus Subclavian Vein Cannulation – Infraclavicular Approach

A Comparative Study Of Internal Jugular Vein Cannulation- Central Approach Versus Subclavian Vein Cannulation – Infraclavicular Approach

Guidelines for the prevention of intravascular catheter-related infections

Focus on peripherally inserted central catheters in critically ill patients

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