Prospective, Randomized Trial of Doppler-Assisted Subclavian Vein Catheterization

Abstract

To examine the rate of success and complications of Doppler-guided subclavian vein catheter insertion compared with standard insertion in patients considered at high risk for failure.

Vascular Access in Oncology Patients

“…During internal jugular venous catheterization, ultrasound guidance (both 2-dimensional [2D] ultrasound-and Doppler-guided methods) clearly reduces the number of complications, failures, and time required for insertion. 36 Conversely, its use for subclavian venous catheterization has yielded inconsistent results in a small number of trials 36,39,40 : limited evidence favored 2D ultrasound guidance for subclavian vein procedures in adults (relative risk 0.14; 95% confidence interval, 0.04 to 0.57). The landmark Vascular Access in Oncology Patients method was more successful than Doppler-guided cannulation for subclavian vein procedures (1.48; 1.03 to 2.14).…”

Comparative study of ultrasound guided subclavian venous cannulation versus conventional technique: Advantages and disadvantages

“…The vein may stay patent even in hypovolemia because the vessel is surrounded by connective tissue, which is attached to adjacent structures 13 . Serious complications can occur more commonly with SCV catheterization than with other routes due to its anatomical structure 5,6 .…”

“…The ipsilateral anterosuperior region of the chest was prepared in a sterile fashion with an appropriate disinfectant. The needle was inserted 1 cm inferior the junction of the middle and lateral thirds of the clavicle towards the supraclavicular notch under posterior surface of the clavicle (infraclavicular approach) 6 .…”

“…3,4 Moreover, young age decreases success rate and increases complication rate. 5,6 When using US scanning for IJV (Internal Jugular Vein) cannulation, we found that the SCV can be easily visualized in the infraclavicular and supraclavicular area. We therefore decided to perform a pilot study to evaluate a new approach for US-guided SCV catheterization.…”

“…In the past ultrasound technique of 'mark and go' which was not real time ultrasound was used for subclavian vein cannulation. 5,6 In this study we have shared our experience of real time ultrasound guided SCV cannulation and their comparison with gold standard conventional-landmark technique in 50 pediatric patients between 2-12 years posted for cardiac surgery.…”