Landmark Central Venous Catheterization is Effective but Ultrasound Helps Even in Experienced Hands

Authors

  • Bruno Monteiro T. Pereira Associate Professor of Surgery, Division of Trauma Surgery, Department of Surgery, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Campinas, SP, Brazil
  • Guilherme Vieira Meirelles Associate Professor of Surgery, Division of Trauma Surgery, Department of Surgery, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Campinas, SP, Brazil; Associate Professor of Surgery, Division of Trauma and Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
  • Carl I. Schulman Associate Professor of Surgery, Division of Trauma and Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
  • Renan Car los Colombari Faculty of Medical Sciences, Division of Trauma Surgery, Department of Surgery, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Campinas, SP, Brazil
  • Arthur S. Magnani Faculty of Medical Sciences, Division of Trauma Surgery, Department of Surgery, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Campinas, SP, Brazil
  • Gustavo Pereira Fraga Chief of Division of Trauma Surgery, Division of Trauma Surgery, Department of Surgery, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Campinas, SP, Brazil

DOI:

https://doi.org/10.17140/EMOJ-1-117

Keywords:

Ultrasound, Infection, Pneumothorax, Hematoma

Abstract

Introduction: A recent report published by the American Society of Anesthesiologists (ASA) task force on central venous access suggests the use of real time ultrasound for placing central venous lines. As in our center there is no ultrasound device specific for this purpose, a decision to test the hypothesis whether anatomic landmark for central venous catheterization is effective in experienced hands was made.
Methods: A retrospective review of a prospectively collected database was performed for the period January 2002 to June 2013. Five hundred fifty patients underwent long-term central venous catheter placement. All procedures were performed by experienced (>50 placements) surgeons utilizing standard techniques.
Results: Males slightly predominated, corresponding to 51.3% (n=282) of the total population. The most frequent cannulated vein was the subclavian vein (n=451/82%). The Right Subclavian Vein (RSV) was the first choice for catheterization (n=410/74.5%). 83.5% (n=459) of the punctures were successful on the first attempt. Complications included arterial puncture (n=36/6.5%), hematoma (n=16/2.9%) and pneumothorax (n=4/0.7%). Ultrasound was used in selective high-risk cases (7.3%).
Conclusion: The data suggests that with proper skill and experience, landmark anatomic position is effective for central venous catheterization, however ultrasound is helpful in specific difficult cases.

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Published

2015-11-04

How to Cite

Bruno Monteiro T. Pereira, Guilherme Vieira Meirelles, Carl I. Schulman, Renan Car los Colombari, Arthur S. Magnani, & Gustavo Pereira Fraga. (2015). Landmark Central Venous Catheterization is Effective but Ultrasound Helps Even in Experienced Hands. Emergency Medicine, 1(4), 109–114. https://doi.org/10.17140/EMOJ-1-117

Issue

Vol. 1 No. 4 (2015): Volume 1 Issue 4 2015

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