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Endocavitary versus Linear Array High-Frequency Probe in Ultrasound-Guided Supraclavicular Subclavian Vein Central Access.

Background: Vascular access is a top priority in the critically ill patients. Cannulation - venous and/or arterial - is the first step in any emergency situation. Ultrasound (US)-guided vascular cannulation was found to have a higher success rate and a decreased incidence of mechanical complications as compared with the landmark one.

Aim: This study aims to compare subclavian vein (SCV) access through supraclavicular (SC) approach by endocavitary (EC) probe technique versus linear array high-frequency probe technique.

Settings and Design: A prospective, randomized controlled study conducted on 60 patients.

Patients and Methods: Study was carried out on 60 adult patients presenting for the surgical intensive care unit in Fayoum University Hospital. Patients were classified into two groups: Group (A) ( n = 30): Catheter was inserted using the EC probe and Group (B) ( n = 30): Catheter was inserted using the linear array high-frequency probe.

Statistical Analysis Used: Student's t -test was applied for calculation of normally distributed variables and Mann-Whitney U-test for nonnormally distributed variables. Categorical data between the groups were compared using Chi-squared test. P < 0.05 indicated a statistically significant difference.

Results: The frequency of successful cannulation of the SCV at first attempt was significantly higher in Group A compared to Group B ( P = 0.044). The number of attempts and the time needed for venous access were significantly lower in Group A compared to Group B ( P = 0.038, <0.001 respectively). No significant difference was found regarding the incidence of posterior wall puncture, arterial puncture, or hematoma, ( P = 0.671, 0.055, 1 respectively).

Conclusion: The use of EC probe technique for Subclavian venous access through the SC approach significantly increased the success rate compared to the linear array high-frequency probe.

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