Central Venous Catheter Insertion Techniques

Not Applicable

Completed

• Conditions: Catheterization, Central Venous
• Interventions: Procedure: Anatomical Landmark technique; Procedure: Ultrasound-guided real-time technique; Procedure: Ultrasound-guided pre location technique

• Registration Number: NCT05387486
• Lead Sponsor: Aga Khan University Hospital, Pakistan

Brief Summary

Investigator compared three techniques of Central venous cannulation (CVC) insertion, Anatomical Landmark, Pre-location Ultrasound and the Real Ultrasound techniques, in cardiac surgical patients.

Detailed Description

Central venous cannulation (CVC) is the cannulation of a large central vein in neck (internal jugular vein), chest (subclavian or axillary) or groin (femoral vein). It is a standard clinical method performed for the monitoring of central venous pressure, temporary haemodialysis, drug administration (drugs irritating peripheral veins, chemotherapy, concentrated vasoactive drugs ) rapid infusion of fluids, inadequate peripheral intravenous access and sampling site for repeated blood sampling. There are different techniques for Central venous cannulation which include anatomical landmark and ultrasound guided (USG) technique.

Previous studies have shown that the successful IJV cannulation using anatomical landmark technique was 85% as compared to ultrasound guided IJV cannulation which was 95%.The median catheterisation time of internal jugular vein via ultrasound guided (USG) is shorter than anatomical landmark technique.

There has been little evidence regarding the use of ultrasound guidance for internal jugular vein cannulation at a tertiary care hospital in our population. Furthermore with widespread availability of ultrasound, Internal Jugular vein can be successfully cannulated with decreasing number of attempts, less time consumption and decrease in the incidence of complications.

Study Timeline

• Study Start: 2019-08-01
• Primary Completion: 2021-04-01
• Study Completion: 2021-07-04
• Study First Submitted: 2022-05-19
• Study First Submitted QC: 2022-05-23
• Study First Posted: 2022-05-24
• Status Verified: 2023-07
• Last Update Submitted: 2023-07-30
• Last Update Posted: 2023-08-01

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 201

Inclusion Criteria

• Age 18-65 years
• ASA (American society of Anesthesiologists) status 1 to 3 requiring central venous catheter during surgical procedure
• ASA (American society of Anesthesiologists) status 4 patients coming for cardiac surgery

Exclusion Criteria

Patients with a history of following

• Previous head and neck surgery
• Head and neck mass or cancer.
• Superior vena cava syndrome.
• Coagulopathy.
• Infection at the cannulation site.
• Previous central venous access.
• Anatomical Changes due to surgery or any pathology in the neck which can lead to distortion of anatomical land marks in the region of puncture.
• Raised intracranial pressure (ICP).
• Patients coming for emergency surgery
• Patients with BMI (Body Mass Index) more than 30
• Patient refusal

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
ALT	Anatomical Landmark technique	-
USG -RT	Ultrasound-guided real-time technique	-
USG-Pre	Ultrasound-guided pre location technique	-

Primary Outcome Measures

Name	Time	Method
Success Rate	Day 1	Success rate will be measured according to the number of attempts. The cannulation of right Internal Jugular Vein within the first three attempts.

Secondary Outcome Measures

Name	Time	Method
Time duration for each technique	Day 1	Measurment of time in minutes
Incidence of Complications	Day 1	Look for carotid puncture, haematoma formation , pneumothorax

Trial Locations

Locations (1)

Aga Khan University hospital; 🇵🇰 Karachi, Sindh, Pakistan