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Study flowchart (CONSORT format)
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Background
The current study was designed to compare the complications and adverse effects of central venous catheter (CVC) insertion under ultrasound guidance in patients with and without coagulopathy.
Materials and Methods
In this clinical trial, 59 patients who needed CVC for various reasons were enrolled. Patients were divided into two groups...
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A central venous catheter is a catheter that is placed directly on a large vein in the body and its tip lies in one of the central veins that is often used on critical care patients. Colonization of bacteria (germ) around the insertion area of the CVC is an area that is very likely to cause infection even though it has been closed by dressing. The...
Citations
... Coagulopathy (DIC, thrombocytopenia): A systematic review by Nasr-Esfahani, Mohammad et al., showed that in coagulopathic patients no cases of serious life-threatening bleeding or complications occurred and that the severity of coagulopathy does not correlate with the bleeding risk [118,119]. But van de Weerdt et al., also showed that there seems to be no correlation between severe thrombocytopenia and minor bleeding complications as oozing or a superficial hematoma. ...
... Nasr-Esfahani, Mohammad et al., concluded, that a correction of coagulation parameters is not necessary for all CVC placements. Additionally, the use of ultrasound guidance resulted in a decreased number of punctures attempts as well as complication rates [118,119]. A review of Peris et al., showed a significant decrease of hematoma after the use of ultrasound guidance [120]. ...
Ultrasound-guided vascular access is rapidly becoming a more critical topic as critical care medicine systems struggle with an increasing number of patients with vascular access problems. Depending on the situation up to 50% of the patients may have no peripheral vascular access sites or access is very difficult to obtain, which can lead to many complications such as bleeding, pneumothorax or prolonged procedure.
... Various landmarks, [1][2][3] formula, [4,5] and complex techniques such as right atrium (RA) electrocardiography [6,7] and transesophageal echocardiography [7,8] have been used to determine venous hemodialysis catheter tip location. As either the advanced sonographic and Background: Long-term central venous catheter (CVC) insertion in dialysis patients is an accepted method of hemodialysis. ...
... Catheter dysfunction or vascular thrombosis and arrhythmias, as well as infection, are among mentioned complications that be related to catheter tip malposition directly. [2,3] Measurement of estimated insertion depth based on the puncture site and the surface anatomical landmark (such as suprasternal notch, xiphoid process, or sternoclavicular prominence) could be more practical and easily identifiable. ...
Background:
Long-term central venous catheter (CVC) insertion in dialysis patients is an accepted method of hemodialysis. The appropriate CVC tip placement may reduce both early and late complications related to catheter and increase patency rate. This study aimed to evaluate a new, simple, and feasible method based on surface anatomy for the proper placement of tunneled CVC in the left internal jugular vein for hemodialysis or chemotherapy.
Materials and methods:
The study was carried out as a quasi-experimental model at Saint Al-Zahra Education Hospital in 2016. A total of forty patients with an indication of left-sided (upper) long-term CVC insertion were enrolled. The length of catheter to be inserted in the left internal jugular vein was considered as the sum of distance from the insertion point of the needle up to sternal notch plus the total distance between the left and right sternoclavicular joint and half-length of the sternum. The right atrium (RA) or superior vena cava-RA junction was the correct region for inserting the catheter tip. The collected data were analyzed using Fisher's exact test and t-test using SPSS (version 22).
Results:
The patients were 63.75 ± 17.96 years of age, weighed 67.33 ± 13.20 kg, and height of 166.92 ± 8.99 cm. Catheters were inserted successfully in 95% of patients (n = 38). No significant relationship was found between the success of new method and age, gender, height, weight, body mass index, and sternum half-length plus the distance between the right and left sternoclavicular joint.
Conclusion:
"The mid - sternal length plus sternoclavicular joints spacing" as a new formula (based on anatomical landmarks) was found practical and safe and could easily be used among adult patients who undergo tunneled CVC in the left internal jugular vein.
