Utility of blind percutaneous jugular venous cannulation in resource-limited settings

Komolafe, Opeyemi; Olatise, Olalekan

doi:10.5301/jva.5000627

Cited by 3 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiple studies have evaluated the barriers to usage of US guidance in North America [ 1 , 3 , 4 ]. While ultrasound use for internal jugular CVC placement has become standard of care in both North America and the United Kingdom since approximately 2002, most developing world countries have not adopted this same standard of care and have been slow to adopt its use [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya

Zaver

Boniface

Wachira

et al. 2018

Emergency Medicine International

View full text Add to dashboard Cite

Background While ultrasound (US) use for internal jugular central venous catheter (CVC) placement is standard of care in North America, most developing countries have not adopted this practice. Previous surveys of North American physicians have identified lack of training and equipment availability as the most important barriers to the use of US. Objective We sought to identify perceived barriers to the use of US to guide CVC insertion in a resource-constrained environment. Methods Prior to an US-guided CVC placement training course conducted at the Aga Khan University Hospital in Nairobi, Kenya, physicians were asked to complete a survey to determine previous experience and perceived barriers. Survey responses were analyzed using summary statistics and the Rank-Sum test based on different specialty, gender, and previous US experience. Results There were 23 physicians who completed the course and the survey. 52% (95% CI: 0.30–0.73) had put in >20 CVCs. 21.7% (95% CI: 0.08–0.44) of participants had previous US training, but none in the use of US for CVC insertion. The respondents expressed agreement with statements describing the ease of the use and improved success rate with US guidance. There was less agreement to statements describing the relative convenience and cost effectiveness of US CVC placement compared to the landmark technique. The main perceived barriers to utilization of US guidance included lack of training and limited availability of US equipment and sterile sheaths. Conclusion Perceived barriers to US-guided CVC placement in our population closely mirrored those found among North American physicians, including lack of training and limited availability of US machines and equipment. These barriers have the potential to be addressed by targeted educational and administrative interventions.

show abstract

Section: Introductionmentioning

confidence: 99%

International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya

Zaver

Boniface

Wachira

et al. 2018

Emergency Medicine International

View full text Add to dashboard Cite

show abstract

“…Excessive force should be avoided to compress the deflated blood vessels to affect the image quality. The hand holding the probe should find a suitable fulcrum to ensure that the blood vessel image is placed in the center of the display (14).…”

Section: Discussionmentioning

confidence: 99%

Application of ultrasound-guided external jugular vein puncture in intensive care unit (ICU) patients with severe sepsis: a randomised trial

et al. 2021

View full text Add to dashboard Cite

Background: Sepsis is one of the most common critical illnesses in intensive care unit (ICU) clinical practice. Intravenous infusion technology is an important method for life support. The commonly used deep vein indwelling is expensive, and the incidence of infection due to long-term placement is high. Ultrasound technology can guide clinical puncture operations in real time and greatly improve the success rate of puncture. In the present study, we aimed to explore the effect of ultrasound-guided external jugular vein puncture and catheterization in patients with sepsis.Methods: From December 2018 to December 2019, a total of 61 patients with sepsis from the ICU or neurology care unit (NCU) were included in the present study and were randomly divided into the experimental group (n=30) and control group (n=31). Ultrasound-guided indwelling cannula needle was used in the experimental group, and blind indwelling cannula needle was used in the control group. The success rate of puncture at first operation, indwelling complications (e.g., bleeding, redness, infection, poor infusion), and operation time of the 2 methods were compared.Results: A comparison of the patients in the control group with the experimental group indicated no significant differences in age, body mass index, sex, temperature, mean aortic pressure, sequential organ failure score, need for vasopressors, central venous pressure, leucocytes, hemoglobin, platelets, albumin, and mechanical ventilation (all P>0.05). The duration of ICU or NCU stay was 5 days in the experimental group compared with 7 days in the control group (P=0.009). Compared with the control group, the experimental group had shorter successful puncture time (4.0 vs. 6.0 min, P<0.001), higher first puncture success rate (93% vs. 71%, Ρ=0.023), and a lower incidence of complications (12.5% vs. 45.0%, P=0.001).Conclusions: For patients with sepsis in ICU, ultrasound-guided puncture is superior to blind manual puncture.

show abstract

“…A similar survey done among French intensivists showed that a proportion of intensivists are still utilising blind landmark technique rather than ultrasound guidance in placing central venous lines. In this trial we tried to define the anatomical relationship between the vein and artery at the upper part of thigh [3,4,5].…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic analysis of the anatomical relationship between femoral vessels in the upper part of thigh in critically ill patients– a cross sectional study

et al. 2018

View full text Add to dashboard Cite

Objective: Femoral vessels are one of the frequently used sites of cannulation in intensive care units. In resource limited settings cannulations are done blindly without ultrasonographic guidance based on a traditional belief that in the upper thigh vein keeps a medial relationship to artery. In this trial we tried to analyse the anatomical relationship of femoral vein to femoral artery using ultrasound in critically ill patients. Methods: This cross sectional study analysed the anatomical relationship of femoral vein to femoral artery at 2cm, 4 cm and 6 cm from the mid inguinal point in both thighs of the patients using ultrasonography. The study was done among patients admitted in a multidisciplinary intensive care unit. Results: Three hundred limbs of one hundred and fifty patients were analysed by ultrasonography. A total of 900 measurements were taken at three different levels of both legs. At 2 cm below the mid inguinal point, in 256 limbs (85.3%) femoral vein was medial to femoral artery (95% Confidence Interval82.82% to 89.14%), at 4 cm below the mid inguinal point, in 210 limbs (70%) femoral vein was posteromedial to femoral artery (95% CI64.47% to 75.13%), and at6 cm below the mid inguinal point in 200 limbs (66.7%) femoral vein was posterior to femoral artery (95% CI 61.02% to 71.98%). Conclusion: Femoral vein showed variable relationship to femoral artery in the upper part of the thigh. As the distance increased from mid inguinal point, variation from normal relationship was also found to be increasing.

show abstract

Utility of blind percutaneous jugular venous cannulation in resource-limited settings

Cited by 3 publications

References 8 publications

International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya

International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya

Application of ultrasound-guided external jugular vein puncture in intensive care unit (ICU) patients with severe sepsis: a randomised trial

Ultrasonographic analysis of the anatomical relationship between femoral vessels in the upper part of thigh in critically ill patients– a cross sectional study

Contact Info

Product

Resources

About