Catheter Malposition, Central Venous Catheterization
Conditions
Brief summary
Central venous catheterization (CVC) via the internal jugular vein (IJV) is a fundamental procedure in anesthesia and intensive care for hemodynamic monitoring, fluid resuscitation, and vasoactive drug administration. While modern clinical guidelines strongly advocate for ultrasound (USG) guidance, the traditional anatomical landmark technique remains widely utilized due to equipment availability or clinician habits. Proper positioning of the catheter tip is critical to prevent severe long-term complications; however, comparative data regarding catheter tip malposition between these two routine techniques-especially when confirmed by postprocedural bedside chest X-ray-require further prospective evaluation. Objective: The primary objective of this prospective observational study is to compare ultrasound-guided versus landmark techniques for internal jugular vein catheterization with respect to catheter tip malposition, as determined by postprocedural bedside chest X-ray. Secondary objectives include the evaluation of the number of needle redirections, first-attempt success rate, total procedure time, and the incidence of mechanical complications (such as accidental arterial puncture or hematoma formation)
Interventions
PROCEDUREUltrasound-Guided Technique
Internal jugular vein catheterization performed with real-time ultrasound visualization of the vein to guide needle insertion.
PROCEDURELandmark Technique
Internal jugular vein catheterization performed using external anatomical landmarks without real-time ultrasound guidance.
Sponsors
Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients aged 18-75 undergoing surgery requiring central venous (internal jugular) catheterization
Exclusion criteria
* Refusal to participate * age \<18 or \>75 * emergency surgery * coagulopathy * infection, prior surgery, or prior cannulation at the insertion site * allergy to ultrasound gel
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of catheter tip malposition | Assessed on postoperative bedside chest X-ray, immediately following the procedure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Procedural Mechanical Complications | During the procedure and up to 24 hours post-operatively. | The occurrence and rate of immediate mechanical complications directly related to the intervention, specifically tracking accidental carotid arterial punctures and hematoma formations. |
Countries
Turkey (Türkiye)
Outcome results
None listed