Prospective, randomized trial of Doppler-assisted subclavian vein catheterization.
Arch Surg
; 133(10): 1089-93, 1998 Oct.
Article
en En
| MEDLINE
| ID: mdl-9790206
ABSTRACT
OBJECTIVE:
To examine the rate of success and complications of Doppler-guided subclavian vein catheter insertion compared with standard insertion in patients considered at high risk for failure.DESIGN:
Prospective, randomized, crossover trial.SETTING:
University-affiliated tertiary care medical center. PATIENTS Two hundred forty patients were enrolled in the study. Patients were stratified for 3 known risk factors (1) prior surgery in the subclavian vein region, (2) prior radiotherapy at the attempted catheterization site, and (3) an abnormal weight-height ratio.INTERVENTIONS:
Subclavian vein catheterization was performed either in standard or Doppler-guided fashion using the Smart Needle (Peripheral Systems Group, Mountain View, Calif), which is a Doppler probe at the tip of a cannulating needle. If subclavian vein catheterization was unsuccessful after 2 attempts, patients were crossed over to the other technique. MAIN OUTCOMEMEASURE:
Successful cannulation of the subclavian vein.RESULTS:
The success rate, either as an initial technique or as a salvage technique, and complication rate were not significantly different with use of the Smart Needle. A subgroup of physicians had a significantly lower success rate using the Smart Needle.CONCLUSIONS:
Doppler guidance did not increase the success rate or decrease the complication rate of subclavian vein catheterization when compared with the standard technique in high-risk patients. Doppler guidance was not more useful than the standard technique as a salvage technique following a previous failure of catheterization. Furthermore, real-time Doppler guidance of subclavian vein catheterization is a technique that is highly operator dependent.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Vena Subclavia
/
Cateterismo Venoso Central
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Ultrasonografía Doppler
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
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Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Arch Surg
Año:
1998
Tipo del documento:
Article
País de afiliación:
Estados Unidos