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IRCT2014081117413N6 IRCT 2014-08-21 Baqiyatallah University of Medical Sciences, Deputy of Research Internal Jugular Vein Catheterization with and without Ultrasonography Guide Evaluation of Success Rate and Complications of Internal Jugular Vein Catheterization with and without Ultrasonography Guide in Emergency Ward: a Randomized Clinical Trial 2014-04-21 anticipated 100 Complete https://irct.ir/trial/16021 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive. N/A Condition 1: Internal jugular vein puncture. Condition 2: Venous catheter complications. Intervention 1: Ultrasound guided jugular vein catheterization. Intervention 2: Jugular vein catheterization using anatomical landmarks. http://nmsjournal.com/?page=article&article_id=23204 Success Rate and Complications of Internal Jugular Vein Catheterization With and Without Ultrasonography Guide<br /> <br /> Background: Central venous catheterization (CVC) is an important procedure in emergency departments (EDs). Despite existence of ultrasonography (US) devices in every ED, CVC is done using anatomical landmarks in many EDs in Iran.<br /> Objectives: This study aimed to compare the traditional landmark method vs. US-guided method of CVC placement in terms of complications and success rate.<br /> <br /> Patients and Methods: In this randomized controlled trial, patients who were candidate for internal jugular vein catheterization, and referred to Baqiyatallah Hospital ED were randomly allocated into US-guided CVC and anatomical landmarks guided CVC groups. Central vein access time, number of attempts, success rate, and complications in each group were evaluated. Mann-Whitney U, chi-square and Fisher exact tests along with Pearson and Spearman correlation coefficients were used to analyze the data.<br /> <br /> Results: Out of 100 patients, 56 were male and 44 were female. No significant differences were found between the US-guided and traditional landmark methods of CVC insertion in terms of age, gender, BMI, and site of catheter insertion. The mean access time was significantly lower in the US-guided group (37.12 ± 17.33 s vs. 63.42 ± 35.19 s, P < 0.001). The mean number of attempts was also significantly lower in the US-guided group (1.12 ± 0.3 vs. 1.58 ± 0.64 times, P < 0.001). Eighty-eight percent of patients in the US-guided group were catheterized in the first attempt, while 50% of patients in the traditional landmark group were catheterized in the second or more attempts (P < 0.001). The success rate was 100% in the US-guided group, while it was 88% in the landmark group (P = 0.013). Moreover, the rate of complications was significantly lower in the US-guided group (4% vs. 24%, P = 0.004).<br /> <br /> Conclusions: The US-guided method for CVC placement was superior to the traditional landmark method in terms of access time, number of attempts, success rate, and fewer complications.<br /> <br /> Keywords: Central Venous Catheterization; Jugular Vein; Ultrasonography
public Hamidreza Karimi Sari
Baqiyatallah University of Medical Sciences, Nosrati alley, Sheikh Bahaei Street, Mollasadra Street, Vanak Square, Tehran, I.R.Iran.
Tehran Iran (Islamic Republic of) +98 21 8126 4354 dr.karimih@yahoo.com Students’ Research Committee (SRC), Baqiyatallah University of Medical Sciences, Tehran, IR Iran scientific Mehrdad Faraji
Baqiyatallah University of Medical Sciences, Nosrati alley, Sheikh Bahaei Street, Mollasadra Street, Vanak Square, Tehran, I.R.Iran.
Tehran Iran (Islamic Republic of) +98 21 8126 4354 m.faraji@bmsu.ac.ir Department of Emergency, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, I Iran (Islamic Republic of) Inclusion criteria: patients referred to emergency ward of Baqiyatallah Hospital needing internal jugular vein catheterization Exclusion criteria: Patients younger than 14 years old; pregnant women; uncontrolled coagulopathies; anticoagulant drugs consumption within the last day no limit no limit Both Y62.6 T82.4 During aspiration, puncture and other catheterization Mechanical complication of vascular dialysis catheter Treatment - Devices Treatment - Devices Ultrasound guided jugular vein catheterization Jugular vein catheterization using anatomical landmarks Internal jugular access time. Timepoint: From needle contacts skin to an established venous flow. Method of measurement: Seconds. Number of attempts. Timepoint: at catheterization time. Method of measurement: Numbers. Catheter related complications. Timepoint: after catheterization. Method of measurement: yes/ no. Baqiyatallah University of Medical Sciences, Deputy of Research Approved 2013-06-14 Baqiyatallah University of Medical Sciences Ethics Committee Baqiyatallah University of Medical Sciences, Nosrati alley, Sheikh Bahaei Street, Mollasadra Street, Vanak Square, Tehran, I.R.Iran. Tehran Iran (Islamic Republic of)