Central Venous Catheter Clinical Trial
Official title:
Comparison Between Ultrasound-guided Out-of-plane Internal Jugular Vein and In-plane Supraclavicular Subclavian Vein Catheterization in Intensive Care Unit Patients—a Randomized Trial
Patients were randomly divided into two groups: ultrasound-guided (US-guided) out-of-plane
internal jugular vein (OOP-IJV) and in-plane supraclavicular subclavian vein (IP-SSV)
catheterization.
For OOP-IJV cannulation, the transducer was placed to identify IJV in short-axis view. The
needle was introduced at an angle of 60° to the skin surface, and advanced under real-time US
guidance until visualizing the tip of the needle inside the vein.
For IP-SSV cannulation, a short-axis view of the IJV was obtained first. The probe was slid
caudally following the IJV until getting the best long-axis view of the SCV. Using an
in-plane approach, the needle was inserted at the base of the transducer at a 30° angle and
advanced under the long axis under real-time US guidance targeting the SCV.
Patients were randomly divided into two groups: ultrasound-guided (US-guided) out-of-plane
internal jugular vein (OOP-IJV) and in-plane supraclavicular subclavian vein (IP-SSV)
catheterization.
For OOP-IJV cannulation, the transducer was placed on transverse position over the patient's
neck at the level of the cricoid cartilage to identify IJV and carotid artery (CA) in
short-axis view. The vein was then centered on the screen. The skin puncture was made in the
center of the US image using a needle attached to a syringe. The needle was introduced at an
angle of 60° to the skin surface, perpendicular to the transducer, and advanced under
real-time US guidance toward the IJV until visualizing the tip of the needle inside the vein.
For IP-SSV cannulation, a short-axis view of the IJV was obtained first. The probe was slid
caudally following the IJV until the junction of the subclavian vein (SCV) and IJV was
reached in the supraclavicular fossa. The probe was then turned slightly and tilted
anteriorly to get the best long-axis view of the SCV and the brachiocephalic vein (BCV).
Using an in-plane approach, the needle attached to a syringe was inserted at the base of the
transducer at a 30° angle and advanced strictly under the long axis of the US probe from
lateral to medial. The needle point was then guided under real-time US guidance targeting the
SCV.
In both groups, catheterization was done through Seldinger technique.
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