TY - JOUR
T1 - Optimization of cannula visibility during ultrasound-guided subclavian vein catheterization, via a longitudinal approach, by implementing echogenic technology
AU - Stefanidis, Konstantinos
AU - Fragou, Mariantina
AU - Pentilas, Nicos
AU - Kouraklis, Gregorios
AU - Nanas, Serafim
AU - Savel, Richard H.
AU - Shiloh, Ariel L.
AU - Slama, Michel
AU - Karakitsos, Dimitrios
PY - 2012
Y1 - 2012
N2 - Objective. One limitation of ultrasound-guided vascular access is the technical challenge of visualizing the cannula during insertion into the vessel. We hypothesized that the use of an echogenic vascular cannula (EC) would improve visualization when compared with a nonechogenic vascular cannula (NEC) during real-time ultrasound-guided subclavian vein (SCV) cannulation in the ICU. Material and Methods. Eighty mechanically ventilated patients were prospectively enrolled in a randomized study that was conducted in a medical-surgical ICU. Forty patients underwent EC and 40 patients were randomized to NEC. The procedure was ultrasound-guided SCV cannulation via the infraclavicular approach on the longitudinal axis. Results. The EC group exhibited increased cannula visibility as compared to the NEC group (92 % ± 3 % versus 85 ± 7 %, resp., P < 0.01). There was strong agreement between the procedure operators and independent observers (k = 0.9, 95 confidence intervals assessed by bootstrap analysis = 0.87 to 0.93; P < 0.01). Access time (12.1 s ± 6.5 versus 18.9 s ± 10.9) and the perceived technical difficulty of the ultrasound method (4.5 ± 1.5 versus 7.5 ± 1.5) were both decreased in the EC group compared to the NEC group (P < 0.05). Conclusions. Echogenic technology significantly improved cannula visibility and decreased access time and technical complexity optimizing thus real-time ultrasound-guided SCV cannulation via a longitudinal approach.
AB - Objective. One limitation of ultrasound-guided vascular access is the technical challenge of visualizing the cannula during insertion into the vessel. We hypothesized that the use of an echogenic vascular cannula (EC) would improve visualization when compared with a nonechogenic vascular cannula (NEC) during real-time ultrasound-guided subclavian vein (SCV) cannulation in the ICU. Material and Methods. Eighty mechanically ventilated patients were prospectively enrolled in a randomized study that was conducted in a medical-surgical ICU. Forty patients underwent EC and 40 patients were randomized to NEC. The procedure was ultrasound-guided SCV cannulation via the infraclavicular approach on the longitudinal axis. Results. The EC group exhibited increased cannula visibility as compared to the NEC group (92 % ± 3 % versus 85 ± 7 %, resp., P < 0.01). There was strong agreement between the procedure operators and independent observers (k = 0.9, 95 confidence intervals assessed by bootstrap analysis = 0.87 to 0.93; P < 0.01). Access time (12.1 s ± 6.5 versus 18.9 s ± 10.9) and the perceived technical difficulty of the ultrasound method (4.5 ± 1.5 versus 7.5 ± 1.5) were both decreased in the EC group compared to the NEC group (P < 0.05). Conclusions. Echogenic technology significantly improved cannula visibility and decreased access time and technical complexity optimizing thus real-time ultrasound-guided SCV cannulation via a longitudinal approach.
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U2 - 10.1155/2012/617149
DO - 10.1155/2012/617149
M3 - Article
C2 - 22593825
AN - SCOPUS:84866258757
SN - 2090-1305
VL - 2012
JO - Critical Care Research and Practice
JF - Critical Care Research and Practice
M1 - 617149
ER -