Comparison of ultrasound guided internal jugular vein cannulation versus supraclavicular approach to brachiocephalic vein cannulation- a prospective randomised clinical study
试验速览
- 阶段
- Phase 3 4
- 状态
- 已完成
- 发起方
- 入组人数
- 110
- 试验地点
- 1
- 主要终点
- First attempt success rate of central venous cannulation
研究概览
简要总结
| Title: ComparisonOf Ultrasound Guided Internal Jugular Vein Cannulation Versus SupraclavicularApproach To Brachiocephalic Vein Cannulation- A Prospective Single BlindRandomised Clinical Study |
**Background and objectives:**Cannulation of veins and arteries is an important aspect of patient care forthe administration of fluids, medications and for monitoring purposes. Internal jugular vein (IJV) cannulation isthe most commonly studied site for central vein cannulation in adults.The Brachiocephalic vein (BCV) has become apreferred option for central venous cannulation in paediatrics, but its use inadults remains limited and very few studies compare the BCV to othercannulation sites. Recently, a retrospective study was done on USG guided BCV cannulationwhich suggested that BCV cannulation is a safe and viable alternative to IJV. The objective of thisstudy is to compare the USG guided out of plane approach to IJV cannulationwith in-plane USG guided supraclavicular approach to BCV cannulation in adultsfor the success rate, first attempt success rate, procedural ease and also torecord the incidence of complications related to either approach.
Methodology: In this study, the 110 patientsrecruited were randomly allocated into two groups of 55 patients each. Thepatients demographic details like age, gender, indication for cannulation,ventilation status and PEEP applied were noted. In group IJV, right internaljugular vein cannulation was performed using ultrasound guidance out of planeapproach and in group BCV, right brachiocephalic vein cannulation was performedusing ultrasound guidance for supraclavicular in-plane approach. Success rateof cannulation, number of attempts to cannulate the veins, ease of guidewireand catheter insertion, cannulation time and any associated complications wererecorded.
Result: The demographic details weresimilar between the two groups. Successful cannulation was 100% in BCV groupand 98.5% in IJV group, which was statistically insignificant. The firstattempt success rate was 81.81% and 76.3% in BCV and IJV group respectively.IJV was collapsed in 14.5% cases and BCV was collapsed in 0.9% cases, which wassignificant. The needle visualisation was better with BCV group (80% in IJVgroup and 94.54% in BCV group), which was statistically significant. The numberof redirections of needle was more in IJV group. The CVC cannulation time andcomplication rates were similar between the groups.
Conclusion: Ultrasound guided supraclavicularin-plane BCV cannulation is a good alternative to USG guided out of plane IJVcannulation, by having a good calibre and better needle visualisation in theBCV group. Overall success rate, first attempt success rate, time duration for cannulationand complication rate remain similar between the two groups.
研究设计
- 研究类型
- Interventional
- 分配方式
- Computer generated randomization
- 盲法
- Participant Blinded
入排标准
- 年龄范围
- 18.00 Year(s) 至 80.00 Year(s)（—）
- 性别
- All
入选标准
- •Patients requiring CVC cannulation in Operation Theatre and Intensive Care Units.
排除标准
- •Uncooperative patients/refusal to consent.
- •Significant coagulopathy INR>1.5/ platelet count<
- •History of previous surgical intervention at cannulation site.
- •Presence of CVC during past 72hrs in the same vein in which present cannulation is planned.
- •Infection/subcutaneous hematoma close to puncture site.
- •Emergency surgeries or emergency clinical situation in ICU.
结局指标
主要结局
First attempt success rate of central venous cannulation
时间窗: At the time of CVC insertion
次要结局
- Complication rate(time of CVC insertion to 24 hour after procedure)
- Cannulation time(At the time of CVC insertion)
- Preocedural difficulty(At the time of CVC insertion)