Supraclavicular or infraclavicular subclavian vein: Which way to go- A prospective randomized controlled trial comparing catheterization dynamics using ultrasound guidance

Prasad, Ram; Soni, Shikha; Janweja, Sarita; Rajpurohit, Jogendra S; Nivas, None Ram; Kumar, Jagdish

doi:10.4103/ija.ija_930_19

Cited by 16 publications

(27 citation statements)

References 17 publications

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“…We used the long-axis in-plane and short-axis out-ofplane techniques during the supraclavicular and infraclavicular approaches, respectively. These combinations make it easy to obtain an adequate view of the subclavian vein and facilitate catheterisation [9,10,18].…”

Section: Discussionmentioning

confidence: 99%

“…A previous meta-analysis comparing the two approaches for landmark-guided subclavian venous catheterisation reported a lower incidence of catheterisation failure and catheter misplacement with the supraclavicular approach [8]. In two previous randomised controlled trials (RCT) comparing the two approaches, the supraclavicular approach was quicker in adults, with a lower incidence of guidewire misplacement in children [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Supraclavicular versus infraclavicular approach for ultrasound‐guided right subclavian venous catheterisation: a randomised controlled non‐inferiority trial

Kim

Yoon

et al. 2021

Anaesthesia

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Infraclavicular and supraclavicular approaches are used for subclavian venous catheterisation. We hypothesised that the supraclavicular approach is non-inferior to the infraclavicular approach in terms of safety during ultrasound-guided right subclavian venous catheterisation. We randomly allocated 401 neurosurgical patients undergoing ultrasound-guided right subclavian venous catheterisation into supraclavicular (n = 200) and infraclavicular (n = 201) groups. We assessed catheterisation-related complications (primary outcome measure) including catheter misplacement and mechanical complications (arterial puncture, haematoma formation, pneumothorax and haemothorax). We also recorded catheterisation success rates and time required for venous puncture and catheterisation. The number (proportion) of patients with catheterisation-related complications was six (3.0%) in the supraclavicular group and 27 (13.4%) in the infraclavicular group, mean difference (95%CI) À10.4% (À15.7 to À5.1%), p < 0.001, with a significant difference also seen for catheter misplacement. Except for a shorter time (median (IQR [range]) required for venous puncture in the supraclavicular group, being 9 (6-20 [2-138]) vs. 13 (8-20 [3-99]) s, the incidence of mechanical complications and other catheterisation characteristics were similar between the two groups. We recommend the supraclavicular approach for ultrasound-guided right subclavian venous catheterisation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Supraclavicular versus infraclavicular approach for ultrasound‐guided right subclavian venous catheterisation: a randomised controlled non‐inferiority trial

Kim

Yoon

et al. 2021

Anaesthesia

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“…Similarly, studies by Prasad R et al . [ 5 ] and Raphael PO et al . [ 12 ] showed that puncture time was less in the SC approach to SCV cannulation.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 4 ] The two approaches of SCV cannulation i.e. supraclavicular (SC) and infraclavicular (IC) have been described[ 5 6 ] and successfully attempted under USG for CVC insertion using the long axis (in-plane) approach. However, the relative efficacy of one over the other remains a matter of debate as the studies evaluating the same are few.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of supraclavicular versus infraclavicular approach of subclavian vein cannulation under ultrasound guidance

Mageshwaran¹,

Singla²,

Agarwal³

et al. 2021

Indian Journal of Anaesthesia

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Background and Aims: Subclavian vein (SCV) cannulation can be performed using either supraclavicular (SC) or infraclavicular (IC) long-axis approach under ultrasound guidance (USG). However, their relative efficacy remains debatable. The aim of this study was to compare these two approaches in terms of safety, ease, success rate, and record the incidence of complications. Methods: We studied 90 adult patients distributed into two groups of 45 each. Data regarding the time taken for first venous puncture, the time required for inserting the catheter, the total number of attempts, the incidence of guidewire misplacement, and other mechanical complications were compared using Student's t-test for quantitative data and Chi-square test for qualitative value. Results: Mean puncture time was significantly lesser in group SC than IC ( P -value < 0.001). Mean catheter insertion time taken was also significantly less in group SC than IC ( P -value = 0.003). The first attempt rate was higher in group SC than IC ( P = 0.013). Guidewire misplacement was seen in the IC group, P = 0.001. No pneumothorax, haemothorax, or arterial puncture were noted in our study in any of the groups. Conclusion: We conclude that for right-sided SCV cannulation using USG in the long axis, the SC approach is superior to the IC approach in terms of overall ease of cannulation. It was associated with a relatively shorter procedure time, higher success rate in the first attempt, lesser incidence of guidewire misplacement, and other complications. It should be considered as an alternative approach to the IC approach in patients requiring central line insertion.

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“…[ 42 43 44 45 46 ] Difficult venous and arterial canulation, insertion of peripheral or central catheters are no longer dependent on the 'feel' of the vessel. [ 47 48 49 50 51 52 ]…”

mentioning

confidence: 99%

Advancing, strengthening and reshaping obstetric critical care with Point-of-Care Ultrasound (POCUS)

Mehdiratta¹,

Kumar²,

Bajwa³

2021

Indian Journal of Anaesthesia

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Supraclavicular or infraclavicular subclavian vein: Which way to go- A prospective randomized controlled trial comparing catheterization dynamics using ultrasound guidance

Cited by 16 publications

References 17 publications

Supraclavicular versus infraclavicular approach for ultrasound‐guided right subclavian venous catheterisation: a randomised controlled non‐inferiority trial

Supraclavicular versus infraclavicular approach for ultrasound‐guided right subclavian venous catheterisation: a randomised controlled non‐inferiority trial

Comparative efficacy of supraclavicular versus infraclavicular approach of subclavian vein cannulation under ultrasound guidance

Advancing, strengthening and reshaping obstetric critical care with Point-of-Care Ultrasound (POCUS)

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