Efficacy and safety of ultrasound-guided cannulation via the right brachiocephalic vein in adult patients

Xia, Rui; Sun, Xingwei; Bai, Xuming; Zhou, Yuhao; Shi, Jian-Quan; Jin, Yong; Chen, Qian

doi:10.1097/md.0000000000013661

Cited by 11 publications

(13 citation statements)

References 19 publications

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“…In our study, we recorded only one pneumothorax in the IP-SSCV group and no hemothoraces occurred. In fact, in the SCV catheterization, the needle trajectory is parallel to the pleura [ 29 ] and the IP technique allows not only the detection of the needle tip advancement within the vein, but also a good visualization of the pleura, decreasing by that the risk of pleural puncture [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of ultrasound-guided internal jugular vein and supraclavicular subclavian vein catheterization in critically ill patients: a prospective, randomized clinical trial

Trabelsi

Hajjej

Drira

et al. 2022

Ann. Intensive Care

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Background The aim of this study was to compare the effectiveness and safety of ultrasound-guided out-of-plane internal jugular vein (OOP-IJV) and in-plane supraclavicular subclavian vein (IP-SSCV) catheterization in adult intensive care unit. Methods A total of 250 consecutive patients requiring central venous catheterization, were randomly assigned to undergo either ultrasound-guided OOP-IJV or IP-SSCV cannulation. All catheterizations were carried out by three physicians. The primary outcome was the first attempt success rate. Ultrasound scanning time, venous puncture time, insertion time, overall access time, number of puncture attempts, number of needle redirections, success rate, guidewire advancing difficulties, venous collapse and adverse events were also documented. Results The first attempt success rate was significantly higher in IP-SSCV group (83.2%) compared to OOP-IJV group (63.2%) (p = 0.001). The IP-SSCV group was associated with a longer ultrasound scanning time (16.54 ± 13.51 vs. 5.26 ± 4.05 s; p < 0.001) and a shorter insertion time (43.98 ± 26.77 vs. 53.12 ± 40.21 s; p = 0.038). In the IP-SCCV group, we recorded a fewer number of puncture attempts (1.16 ± 0.39 vs. 1.47 ± 0.71; p < 0.001), needle redirections (0.69 ± 0.58 vs. 1.17 ± 0.95; p < 0.001), difficulties in guidewire advancement (2.4% vs. 27.4%; p < 0.001), venous collapse (2.4%, vs. 18.4%; p < 0.001) and adverse events (8.8% vs. 13.6%; p = 0.22). Conclusions The IP-SSCV approach is an effective and a safe alternative to the classic OOP-IJV catheterization in critical adult patients. Trial registration: Clinicaltrials.gov, NCT03879954. Registered March 19, 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03879954.

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Section: Discussionmentioning

confidence: 99%

Comparison of ultrasound-guided internal jugular vein and supraclavicular subclavian vein catheterization in critically ill patients: a prospective, randomized clinical trial

Trabelsi

Hajjej

Drira

et al. 2022

Ann. Intensive Care

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“…Furthermore, a valuable movie indicating a detailed technique and methodology can be previewed in an electronic journal [14]. Additional reported benefits include lower mean access time and mean attempt number [13] and reduced complications, such as hematoma, carotid puncture, hemothorax, and pneumothorax [13, 15, 16]. However, the authors in that report did not evaluate other late incidental complications, including local site infection, deep venous thrombosis, CRBSI, and catheter occlusion.…”

Section: Discussionmentioning

confidence: 99%

“…But ultrasound-guided cannulation comprehensively achieved an extremely high success rate, 98.32%, in a recent report [15]. Ultrasound-guided cannulation can be adopted at any site—internal jugular vein, subclavian vein, brachiocephalic vein, and so on—and is not limited to adult or child patients [12–15, 17–19]. The wide acceptance of ultrasound-guided insertion makes it a standard procedure for CVC/PICC [17, 20].…”

Section: Discussionmentioning

confidence: 99%

Effect of ultrasound-guided central venous catheter insertion on the incidence of catheter-related bloodstream infections and mechanical complications

et al. 2019

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Background Central venous catheters (CVCs) are necessary for critically ill patients, including those with hematological malignancies. However, CVC insertion is associated with inevitable risks for various adverse events. Whether ultrasound guidance decreases the risk of catheter-related infection remains unclear. Methods We observed 395 consecutive CVC insertions between April 2009 and January 2013 in our hematological oncology unit. Because the routine use of ultrasound guidance upon CVC insertion was adopted based on our hospital guidelines implemented after 2012, the research period was divided into before December 2011 (early term) and after January 2012 (late term). Results Underlying diseases included hematological malignancies and immunological disorders. In total, 235 and 160 cases were included in the early- and late term groups, respectively. The median insertion duration was 26 days (range, 2–126 days) and 18 days (range, 2–104 days) in the early- and late term groups, respectively. The internal jugular, subclavian, and femoral veins were the sites of 22.6, 40.2, and 25.7% of the insertions in the early term group and 32.3, 16.9, and 25.4% of the insertions in the late term group, respectively. The frequency of catheter-related bloodstream infection (CRBSI) was 1.98/1000 catheter days and 2.17/1000 catheter days in the early- and late term groups, respectively. In the subgroup analysis, the detected causative pathogens of CRBSI did not differ between the two term groups; gram-positive cocci, gram-positive bacilli, and gram-negative bacilli were the causative pathogens in 68.9, 11.5, and 14.8% of the cases in the early term group and in 68.2, 11.4, and 18.2% of the cases in the late term group, respectively. In the multivariate analysis to determine the risk of CRBSI, only age was detected as an independent contributing factor; the indwelling catheter duration was detected as a marginal factor. A significant reduction in mechanical complications was associated with the use of ultrasound guidance. Conclusions Ultrasound-guided CVC insertion did not decrease the incidence of CRBSI. The only identified risk factor for CRBSI was age in our cohort. However, we found that the introduction of ultrasound-guided insertion triggered an overall change in safety management with or without the physicians’ intent.

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“…[2][3][4][5] Compared with the peripherally inserted central catheter (PICC) or central venous catheter (CVC), the TIVAP has many advantages and is more readily accepted by patients because of its long service life, ease of nursing, and lack of impact on the quality of life. [6][7][8][9][10][11][12] TIVAP has been widely used in the clinic in recent years, and clinicians have gradually observed a series of clinical complications, such as arterial puncture, pneumothorax, thrombosis, and catheter rupture. 6 These complications not only cause additional pain to patients but also delay treatment and even endanger patients' lives.…”

Section: Introductionmentioning

confidence: 99%

Perioperative and Postoperative Complications of Supraclavicular, Ultrasound-Guided, Totally Implantable Venous Access Port via the Brachiocephalic Vein in Adult Patients: A Retrospective Multicentre Study

Yu¹,

Sun²,

Bai³

et al. 2021

TCRM

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Purpose The totally implantable venous access port (TIVAP) provides patients with safe, effective and long-term convenient venous access for the administration of medications such as chemotherapy drugs. The implantation and long-term use of TIVAP are related to thrombosis, infection and other complications. In this study, the medical records of multicentre patients were collected, and the perioperative and postoperative complications were retrospectively analysed to objectively evaluate the safety of the implantation of supraclavicular, ultrasound-guided TIVAP via the brachiocephalic vein (BCV). Patients and Methods We retrospectively analysed the clinical data of 433 adult patients who had undergone ultrasound-guided TIVAP implantation via the BCV at four hospitals in China from March 2018 to May 2019. The success rates of the first puncture, operation time, and perioperative and postoperative complications were analysed. Results All the TIVAPs were implanted successfully (100%). The average TIVAP carrying time was 318.15 ±44.22 days (range: 38–502 days) for a total of 197,694 catheter days. The success rate of the first puncture was 94.92% (411/433), and the average operation time was 29.66 ±7.45 min (range: 18–60 min). The perioperative complications included arterial puncture in 4 patients and pneumothorax in 1 patient. The incidence of postoperative complications was 5.08% (22/433), including poor incision healing (n = 2), catheter-related infection (n = 3), port infection (n = 6), thrombosis (n = 2) and fibrin sheath formation (n = 8). Another patient had infusion disturbance 2 days after the operation, and chest X-ray showed bending at the connection between the catheter and port. No other serious complications occurred, such as catheter rupture and drug leakage. The total incidence of complications was 6.24% (27/433). Conclusion This study showed excellent tolerance of supraclavicular, ultrasound-guided BCV puncture to implant TIVAP and a low incidence of complications. As a safe and effective method of TIVAP implantation, it can provide a new choice for clinicians.

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Efficacy and safety of ultrasound-guided cannulation via the right brachiocephalic vein in adult patients

Cited by 11 publications

References 19 publications

Comparison of ultrasound-guided internal jugular vein and supraclavicular subclavian vein catheterization in critically ill patients: a prospective, randomized clinical trial

Comparison of ultrasound-guided internal jugular vein and supraclavicular subclavian vein catheterization in critically ill patients: a prospective, randomized clinical trial

Effect of ultrasound-guided central venous catheter insertion on the incidence of catheter-related bloodstream infections and mechanical complications

Perioperative and Postoperative Complications of Supraclavicular, Ultrasound-Guided, Totally Implantable Venous Access Port via the Brachiocephalic Vein in Adult Patients: A Retrospective Multicentre Study

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