Central Venous Catheters
Conditions
Brief summary
Although ultrasound-guided catheterization of the subclavian vein is becoming standard procedure in anesthetic practice, failure to align the needle and the transducer still can lead to possibly complications. In this study, we proposed a new alignment method, namely Aiming Method. The purpose of this study is to investigate whether the use of this aiming method improved resident volunteers' performance of ultrasound-guided SC insertion in real patients. Specifically, residents were asked to perform three different methods: landmark techniques, ultrasound-guided with aiming method and ultrasound-guided plus needle guide techniques.
Interventions
PROCEDUREsubclavian vein catheterization
Here we introduced a new freehand method, named as Aiming Method, which facilitated the alignment of injection needles with ultrasound beams. During this aiming method, patient is still positioned in Tredelenburg with the arm abducted to 90° and no needle guidance will be used.
PROCEDURElandmark techniques
The patient is positioned in Tredelenburg with the arm abducted to 90°. Venipuncture should occur 1 cm lateral to the curvature of the middle third of the clavicle with the needle pointing horizontally directed at the sternal notch. If subclavian vein is missing at the first try, withdraw the needle and direct horizontally at the cricoid cartilage at the second try.
PROCEDUREUltrasound-guided plus needle guide techniques
Subclavian vein catheterization is performed under ultrasound guidance with in-plane technique. The patient is positioned in Tredelenburg with the arm abducted to 90°. During the needle insertion, the needle is secured in the needle guidance device which keeps the alignment of needle and ultrasonic beam.
Sponsors
Daping Hospital and the Research Institute of Surgery of the Third Military Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* 18 years to 70 years * American Society of Anesthesiologists (ASA) Physical Status Ⅰ-Ⅲ * Elective surgery patients requiring subclavian vein catheterization
Exclusion criteria
* Local anatomic abnormalities in subclavicular area * Preexisting subclavian vein thrombosis or coagulation disorders * Refusal of subclavian vein catheterization
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Procedural time | 24 hours | the time from skin break to guide wire was positioned into the subclavian vein |
| Number of skin breaks | 24 hours | number of skin punctures |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of arterial puncture | 24 hours | aspiration of arterial blood during needle insertion or local haematoma in ultrasound image |
| The incidence of pneumothorax | 24 hours | aspiration of air during needle insertion, or thoracic ultrasonography, or chest radiography |
Countries
China
Outcome results
None listed