Use of ultrasound for central venous catheter placement

doi:10.1186/cc6301

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Introduction
Methods
Results
Conclusion
References

Critical Care
Volume 12
Suppl 2

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Angelini T
Bevilacqua L
Forfori F
Licitra G
DeSimone L
Giunta F

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Bevilacqua L
Forfori F
Licitra G
DeSimone L
Giunta F
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This article is part of the supplement: 28th International Symposium on Intensive Care and Emergency Medicine .

Poster presentation

Use of ultrasound for central venous catheter placement

T Angelini¹, L Bevilacqua¹, F Forfori², G Licitra², L DeSimone² and F Giunta²

¹Scuola di Specializzazione in Anestesia e Rianimazione, Pisa, Italy.

²Department of surgery, AOUP, Pisa, Italy.

from 28th International Symposium on Intensive Care and Emergency Medicine
Brussels, Belgium. 18–21 March 2008

Critical Care 2008, 12(Suppl 2):P80doi:10.1186/cc6301

The electronic version of this abstract is the complete one and can be found online at: http://ccforum.com/content/12/S2/P80

Published:

13 March 2008

Introduction

The placement of a central venous catheter is a common practice in the ICU and the incidence of mechanical complications occurs is 5–19% of patients. In this study we compare the ultrasound approach with classic landmark technique in terms of reduction of mechanical complications and the number of attempts needed for the cannulation of the internal jugular vein.

Methods

We examined 31 patients admitted to the ICU: in 20 of them the cannulation of the internal jugular vein was obtained using real-time ultrasound guidance, while in 11 patients we employed the landmark technique (axial approach). We recorded the number of complications and the number of attempts, correlating with the experience of the operator. All data were statistically examined with Student's t test (number of attempts) and Fisher's test for count of odds ratio (incidence of complications).

Results

We reported 9% of complications in the landmark group (one accidental arterial puncture) and 6% in the ultrasound group (one pneumothorax). The odds ratio for these data is 0.5 (95% CI = 0.006–45.4). We found a statistically significant difference in the number of attempts performed, with a lower value in the ultrasound group (mean ± SD, ultrasound 1.1 ± 0.30 vs landmark technique 1.7 ± 0.78; P = 0.034). No difference in the number of attempts was evidenced by the experience of the operator using the ultrasound approach. See Figure 1.

Figure 1.

Conclusion

Our data confirm that use of ultrasound for central venous catheter placement is safer and is associated with a lower risk of complications than the classical approach, especially for low-experience operators.

References

McGee D, Gould M: Preventing complication of central venous catheterization.
N Engl J Med 2003, 348:1123-1133. PubMed Abstract | Publisher Full Text
Maecken T: Ultrasound imaging in vascular access.
Crit Care Med 2007, 35:S178-S185. PubMed Abstract | Publisher Full Text
Karakitsos D, et al.: Real-time ultrasound-guided catheterisation of the vein: a prospective comparison with the landmark technique in critical care patients.
Crit Care 2006, 10:R162. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text

This article is part of the supplement: 28th International Symposium on Intensive Care and Emergency Medicine .

Use of ultrasound for central venous catheter placement

Introduction

Methods

Results

Conclusion

References

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