ULTRASONOGRAPHY GUIDANCE FOR CENTRAL VENOUS CATHETER – A PROSPECTIVE STUDY FOR PATIENT’S SAFETY & QUALITY CARE

BACKGROUND: Context: A central venous line access is very importance in management of the critically ill patients even though, it may carry a risk of complications. AIMS: Objective of this study is to assess and compare success rate, attempts of cannulation and complications like inadvertent arterial puncture, hematoma, and pneumothorax occurred during the Central Venous Catheter (CVC) placement using ultrasound guidance (USG) & anatomical landmark guidance (ALG). SETTINGS AND DESIGN: The prospective randomized study was carried out in 64 patients for right sided internal jugular vein CVC placement. Using computer generated randomization chart, all patients were divided randomly into two groups: Group USG and Group ALG. METHODS AND MATERIAL: Right sided internal jugular vein (IJV) was cannulated with the guidance of ultrasound and anatomical landmark, respectively in group USG and group ALG. Patients were observed & data were recorded for success rate, no. of attempts, and complications like inadvertent arterial puncture, hematoma, and pneumothorax STATISTICAL ANALYSIS USED : Database was analysed using graphpad prism 5 software. RESULTS: Success rate is 31 out of 32 (96.88%) in group USG while 24 out of 32 (75%) in group ALG (p =0.031). Placement of central venous catheter with 1st attempt is 28 out of 32 (87.50%) in group USG while 18 out of 32 (56.25%) in group ALG (p =0.012). Hematoma and overall complications are 0 versus 6 (18.75%) in group USG & ALG respectively. CONCLUSIONS: Ultrasound guided central venous catheter placement is easy, safer & prudent approach than the anatomical landmark guided central venous catheter placement. KEY MESSAGES: We believe that Ultrasound guidance should be encouraged for all central venous catheter placements in patients & thereby improving patient's safety and quality care.