Peripherally central catheter insertion in a prone COVID-19 patient

Longo, Ferdinando; Strumia, Alessandro; Schiavoni, Lorenzo; Martuscelli, Matteo; Claps, Francesca; Piliego, Chiara; Remore, Luigi Maria

doi:10.1177/11297298211022249

J Vasc Access

2021

DOI: 10.1177/11297298211022249

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Peripherally central catheter insertion in a prone COVID-19 patient

Ferdinando Longo

Alessandro Strumia

Lorenzo Schiavoni

et al.

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2024

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Cited by 2 publications

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Ultrasound-Guided Venous Catheter Placement in Prone Position

Yu,

Wang,

Kung

et al. 2024

J Intensive Care Med

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The prone position is often used for patients with adult respiratory distress syndrome and specific surgical postures. When performing venous cannulation in this position, it is important to have a structured review to introduce the available major veins and ultrasound-guided procedure. In this review, we discuss the techniques of ultrasound-guided cannulation and provide insights into various aspects, including the anatomical locations of veins, vein sizes, placement techniques, surrounding structures at risk, and reported experiences with catheter placements. Eight major veins can be accessed in the prone position: the internal jugular vein, external jugular vein, brachiocephalic vein, basilic vein, mid-thigh femoral vein, popliteal vein, posterior tibial vein, and small saphenous vein. To minimize the risk of venous thromboembolism, the ratio of catheter diameter to vessel diameter should be less than 0.67. The review also presents the minimal requirement of venous diameter for different catheters in a tabulated form. For larger veins, real-time ultrasound guidance with the long-axis view/in-plane technique is suggested, while for smaller vessels, the short-axis view/out-of-plane technique is recommended. The review includes sonographic illustrations of the two techniques and surrounding arteries and nerves for the eight major veins. The aim of this review is to help clinicians assess the eight major veins and safely insert various types of catheters for patients in the prone position.

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Ultrasound-Guided Venous Catheter Placement in Prone Position

Yu,

Wang,

Kung

et al. 2024

J Intensive Care Med

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Central venous accesses in prone position during the pandemic period: A narrative review

Longo,

De Caris,

Strumia

et al. 2024

J Vasc Access

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The unprecedented challenges posed by the global COVID-19 pandemic have magnified the significance of managing intensive care patients in prone positions, particularly those requiring mechanical ventilation. Central venous access is crucial for delivering essential therapies to patients, particularly in intensive care settings. However, the shift in patient management during the pandemic, necessitating prone positioning for improved oxygenation, presented unique hurdles in maintaining and establishing central venous access. Before the pandemic, scant literature detailed the insertion of vascular access devices in prone or unconventional positions. Limited case reports and letters highlighted the feasibility of procedures like ultrasound-guided central catheter placement in patients undergoing surgery or with specific clinical needs. During the pandemic, a surge in case reports and series illuminated the complexities faced by clinicians in maintaining vascular access during pronation procedures. These reports delineated critical scenarios, ranging from rapid clinical deterioration necessitating immediate interventions to challenges with vascular access device (VAD) malfunctions or misplacements during prone maneuvers. Patient selection and device types emerged as critical considerations. Various scenarios, including patients transitioning to prone position from non-invasive ventilation and those requiring additional access for therapies like dialysis, posed challenges in device selection and placement. Successful VAD insertion techniques in prone patients encompassed multiple anatomical sites, including the internal jugular, brachial, femoral, and popliteal veins. However, challenges persisted, particularly with respect to anatomical variations and technical complexities in cannulation. Further research, standardized protocols, and randomized studies are needed to refine and validate the proposed strategies in both pandemic and non-pandemic settings.

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Peripherally central catheter insertion in a prone COVID-19 patient

Cited by 2 publications

References 4 publications

Ultrasound-Guided Venous Catheter Placement in Prone Position

Ultrasound-Guided Venous Catheter Placement in Prone Position

Central venous accesses in prone position during the pandemic period: A narrative review

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