JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Ultrasound-guided central venous cannulation is superior to quick-look ultrasound and landmark methods among inexperienced operators: a prospective randomized study

Norair Airapetian, Julien Maizel, François Langelle, Santhi Samy Modeliar, Dimitrios Karakitsos, Herve Dupont, Michel Slama
Intensive Care Medicine 2013, 39 (11): 1938-44
24026296

OBJECTIVE: Quick-look ultrasound with a skin mark (UM) has been frequently used for central vein cannulation. The aim of this study is to compare this method with landmark (LM) and ultrasound-guided (UG) cannulation of jugular and femoral veins by inexperienced operators.

DESIGN: Prospective randomized single-center study.

SETTING: A medical intensive care unit (ICU) of a university medical center.

PATIENTS: Patients requiring jugular or femoral central cannula placement.

INTERVENTION: Each inexperienced resident randomly inserted a central venous line using the UM, LM or UG technique.

MEASUREMENTS AND FINDINGS: The primary outcome was the success rate, and secondary outcomes were the placement time, number of attempts, mechanical complication rate, and catheter colonization rate. A total of 118 patients were randomly assigned to the three groups. The mean age of patients included in the study was 65 ± 15 years, and the mean Simplified Acute Physiology Score 2 (SAPS2) was 57 ± 20. The success rate was higher in the UG group than in the LM and UM groups (100, 74, and 73 %, respectively; p = 0.01). The total number of mechanical complications was higher in the LM and UM groups than in the UG group (24 and 36 versus 0 %, respectively; p = 0.01). The number of attempts and the access time were higher in the LM group than in the UG group, but not compared with the UM group. No difference in terms of catheter colonization was observed between the three groups.

CONCLUSIONS: Ultrasound-guided cannulation of the internal jugular or femoral vein by inexperienced residents appears to be more reliable than the LM or UM methods and was associated with a lower mechanical complication rate among ICU patients.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
24026296
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"