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Ultrasound‐guided catheterisation of the subclavian vein: freehand vs needle‐guided technique
Author(s) -
Maecken T.,
Heite L.,
Wolf B.,
Zahn P. K.,
Litz R. J.
Publication year - 2015
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13187
Subject(s) - medicine , catheter , subclavian vein , ultrasound , radiology , venous access , surgery , vein , prospective cohort study , nuclear medicine
Summary The objective of this prospective, randomised study was to examine the impact of a multi‐angle needle guide for ultrasound‐guided, in‐plane, central venous catheter placement in the subclavian vein. One hundred and sixty patients were randomly allocated to two groups, freehand or needle‐guided, and then 159 catheterisations were analysed. Cannulation of the first examined access site was successful in 96.9% of cases with no significant difference between groups. There were three arterial punctures and no other severe injuries. Catheter misplacements did not differ between the groups. Higher success rates within the first and second attempts in the needle‐guided group were observed (p = 0.041 and p = 0.019, respectively). Use of the needle guide reduced the access time from a median (IQR [range]) of 30 (18–76 [6–1409]) s to 16 (10–30 [4–295]) s; p = 0.0001, and increased needle visibility from 31.8% (9.7%–52.2% [0–96.67]) to 86.2% (62.5%–100% [0–100]); p < 0.0001. A multi‐angle needle guide significantly improved aligning the needle and ultrasound plane compared with the freehand technique when cannulating the subclavian vein. Use of the guide resulted in faster access times and increased success at the first and second attempts.