Central venous catheterization site choice based on anatomical landmark technique: a systematic review and meta-analysis.
J Anesth
; 35(6): 801-810, 2021 12.
Article
em En
| MEDLINE
| ID: mdl-34341863
ABSTRACT
BACKGROUND:
Internal jugular vein catheterization (IJVC) and subclavian vein catheterization (SCVC) have been the most preferred central venous catheterizations (CVC) clinically. Individual preference and institutional routine dominate the traditional CVC choice; however, it is lack of high-level evidence. We sought to provide better clinical strategy for CVC site choice based on anatomical landmark technique between IJVC and SCVC.METHODS:
We systematically reviewed eligible studies from PubMed, OVID, Cochrane and ClinicalTrials.Gov till February 2020. The primary outcomes were catheterization time and overall success rate, and the secondary outcomes were the first-attempt success rate and the instant mechanical complications. Ethical problems are not applicable.RESULTS:
A total of 3378 patients from 7 studies were included in the analyses. Neither difference was found on the catheterization time (SMD 95% CI -0.095-0.124, p = 0.792), nor any difference on the overall success rate (RR = 1.017, 95% CI 0.927-1.117, p = 0.721, I2 = 89.6%) between the 2 procedures. However, subgroup analyses showed overall success rate of IJVC was significantly lower than that of SCVC (RR = 0.906, 95% CI 0.850-0.965, p = 0.002) in adults. The first-attempt success rate of IJVC group was higher in the adults (RR = 1.472, 95% CI 1.004-2.156, p = 0.047). No significance was detected in arterial injury (RR = 1.137, 95% CI 0.541-2.387, p = 0.735) and pneumothorax (RR = 0.600, 95% CI 0.32-1.126, p = 0.112) between the two procedures. Hematoma was significantly more in IJVC group than that in SCVC group (RR = 2.824, 95% CI 1.181-6.751, p = 0.02).CONCLUSIONS:
Compared with IJVC, SCVC shows a higher overall success rate while a lower first-attempt success rate in adults, and has involved with less hematoma. PROSPERO REGISTRATION CRD42020165444.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumotórax
/
Cateterismo Venoso Central
Tipo de estudo:
Systematic_reviews
Aspecto:
Ethics
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Anesth
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
China