Practical guide for safe central venous catheterization and management 2017

,

doi:10.1007/s00540-019-02702-9

Cited by 66 publications

(63 citation statements)

References 89 publications

(86 reference statements)

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“…The IJV catheterization is used in a variety of situations, including relatively short-term use, such as emergency or critical care, and long-term use, such as chemotherapy and hemodialysis [11]. Recently, it has become possible to safely and easily insert a catheter into an IJV by using ultrasound guidance [4,12].…”

Section: Discussionmentioning

confidence: 99%

Anatomical Morphology Analysis of Internal Jugular Veins and Factors Affecting Internal Jugular Vein Size

2020

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Background and objectives: There is a paucity of research on the shape of internal jugular vein (IJV) and their association with an individual’s morphology and various chronic diseases. Therefore, this study aimed to analyze the anatomy of the IJV across various patients and to relate the differences in anatomy to basic patient characteristics. Materials and Methods: This retrospective study included a total of 313 patients who underwent contrast-enhanced neck computed tomography between January 2017 and December 2018. The circumferences of the right and left IJVs were measured at three locations (hyoid bone, cricoid cartilage, and first thoracic vertebra) and parameters affecting the size of the IJV were analyzed. Results: The right IJV was significantly larger than the left IJV at each position (p < 0.001), and the area of the lumen was the largest at the cricoid cartilage level (p < 0.001). After dividing the right IJV data into two groups (above and below the median area), multivariate logistic regression analysis showed that age (odds ratio (OR) 1.040; 95% confidence interval (CI) 1.022–1.058, p < 0.001) and body mass index (BMI, OR 1.080; 95% CI 1.011–1.154, p = 0.0.23) affected size. Conclusions: The right IJV is larger than the left and has a rhomboid morphology. Age and BMI are significant factors affecting the IJV size.

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Section: Discussionmentioning

confidence: 99%

Anatomical Morphology Analysis of Internal Jugular Veins and Factors Affecting Internal Jugular Vein Size

2020

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“…To reduce the risk of this occurrence, when catheters are introduced, some precautions are needed, such as incision in the skin at an adequate depth, elimination of excessive force when inserting the vessel dilator and catheter on it, keeping its introduction absolutely immobilized without abrupt maneuvers [ 42 ], observing the fluid flow as the catheter is inserted, and not advancing the catheter when there is resistance [ 26 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Knot Formation in a Central Venous Catheter

et al. 2021

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Patient: Male, 63-year-old Final Diagnosis: Spontaneous knot formation in central venous catheter Symptoms: Central venous catheter whit any flow • associated with pain at the insertion site of the access Medication: — Clinical Procedure: Central venous catheterization Specialty: General and Internal Medicine • Surgery Objective: Challenging differential diagnosis Background: Central venous catheterization (CVC) is indispensable in the management of critically ill patients in the emergency room and intensive care units, either to avoid the various peripheral punctures and vasoactive drugs administration in decompensated patients, or even to administer parenteral nutrition. CVC is an invasive procedure with possible mechanical, infectious, and thrombotic complications. The complete knotting of a catheter is a rare complication. The aim of this study is to report a case of a simple tight knot 2 cm from the catheter tip. We provide insights for early identification of catheter knotting, as well as its management. Case Report: A 63-year-old man with a previous history of angioplasty and non-pharmacological coronary stent in a marginal branch of the circumflex coronary artery evolved to junctional bradycardia and cardiogenic shock and was transferred to the reference hospital. He had a CVC inserted in the right jugular vein; however, it did not have any blood flow. The hypothesis of catheter knotting was suggested and confirmed through a chest X-ray. Venotomy was performed and it was successfully removed. Conclusions: Knotting in CVC obstruction is a rare complication. Recognition of this complication is essential to avoid major complications, such as catheter fragmentation and venous injury. Radiological follow-up after the procedure in patients with difficult anatomy is essential, and echo-guided catheterization should be encouraged when available. Despite the rarity of a knotted intravascular catheter, it is important to note this possible late complication that must be considered in the absence of catheter blood flow.

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“…Therefore, the goal should be to reduce the number of punctures and shorten the intervention time in central venous catheterizations. Four important factors are believed to directly affect the success rate of central venous catheterizations: patient cooperation, the experience level of the operator, technique, and the suitability of the instruments used [ 10 , 11 ]. All US-guided CVA procedures in this study were performed by the same senior pediatric surgeon who had performed more than 300 procedures.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Central Venous Access With Different Anesthesia Methods in Neonatal Intensive Care Unit

Okumuş¹,

Zübarioğlu²

2021

Cureus

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Background: Ultrasound (US)-guided internal jugular vein (IJV) catheterization in newborns is usually performed in the operating room with general anesthesia. This study aimed to show that US-guided IJV catheterization can be successfully performed with local anesthesia and sedation in newborns.Methods: The files of newborn patients who underwent US-guided IJV catheterization between May 2017 and May 2020 were examined. Two groups were created according to the type of anesthesia applied during the procedure. The general characteristics of the newborns, the success of the procedure, the number of punctures, and the complication rates in both groups were compared.Results: A total of 53 newborns were included in this study. Of the 62 procedures, 30 were performed under general anesthesia (group A) and 32 were performed under sedation (group B). Twenty-six (86.6%) of the newborns in group A and 19 (59.3%) in group B were catheterized at the first puncture. The median puncture numbers in groups A and B were 1 (1-3) and 1 (1-5), respectively. All of the patients in group A were successfully catheterized (n = 30; 100%), and all but one in group B could be catheterized (n = 32; 96.8%).Conclusion: No significant differences in complications or procedural success rates were observed between newborns undergoing general anesthesia or sedation. US-guided IJV catheterization can be safely performed with sedation alone.

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Practical guide for safe central venous catheterization and management 2017

Cited by 66 publications

References 89 publications

Anatomical Morphology Analysis of Internal Jugular Veins and Factors Affecting Internal Jugular Vein Size

Anatomical Morphology Analysis of Internal Jugular Veins and Factors Affecting Internal Jugular Vein Size

Spontaneous Knot Formation in a Central Venous Catheter

Ultrasound-Guided Central Venous Access With Different Anesthesia Methods in Neonatal Intensive Care Unit

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