Document Detail

Pulsed Doppler ultrasonography guidance for catheterization of the subclavian vein: a randomized study.
MedLine Citation:
PMID:  9605678     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Catheterization of the subclavian vein may lead to severe complications. The current randomized study compared a technique of pulsed Doppler ultrasonography guidance and the standard method for subclavian vein catheterization. METHODS: Standard and Doppler ultrasonography guidance methods were performed by the same physician in 286 patients, 143 in each group. Primary end points were immediate complications (arterial puncture, pneumothorax, wrong position of catheter tip), failures, the number of subclavian vein catheterizations with immediate complication or failure, the number of skin punctures per catheterization, and the time to placement of the guide wire. The secondary end points were the determination of predicting factors of successful cannulation in each group. RESULTS: Both groups were similar according to morphologic parameters of the patients. A greater number of subclavian vein catheterizations were performed on the right side using Doppler guidance (105 vs. 73, P < 0.01). Doppler guidance decreased complications (5.6% vs. 16.8%, P < 0.01), largely because of a smaller number of catheters for which the tip was defined to be in incorrect position (0.7% vs. 7.7%, P < 0.01). The time to catheterization was longer with Doppler guidance (300 vs. 27 s, P < 0.001). Failures, catheterizations of the subclavian vein with immediate complications or failure, and the total number of skin punctures per catheterization were similar in both groups. Using Doppler guidance, the presence of a good Doppler signal (124 of 143) was predictive of successful catheterization (123 successful cannulations, P < 0.001). CONCLUSIONS: Doppler guidance reduces the incidence of inappropriately positioned subclavian catheters.
J Y Lefrant; P Cuvillon; J F Bénézet; M Dauzat; P Peray; G Saïssi; J E de La Coussaye; J J Eledjam
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesiology     Volume:  88     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-06-16     Completed Date:  1998-06-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1195-201     Citation Subset:  AIM; IM    
Department of Anesthesiology and Critical Care, University-Hospital of Nîmes, France.
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MeSH Terms
Aged, 80 and over
Catheterization, Central Venous / adverse effects,  methods*
Middle Aged
Subclavian Vein / ultrasonography*
Ultrasonography, Doppler, Pulsed / instrumentation*

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