Landmark Central Venous Catheterization is Effective but Ultrasound Helps Even in Experienced Hands
A recent report published by the American Society of Anesthesiologists task force
on central venous access suggests the use of real time ultrasound for placing central
venous lines.
As in our center there is no ultrasound device specific for this purpose, a decision
to test the hypothesis whether anatomic landmark for central venous catheterization is effective
in experienced hands was made.
A retrospective review of a prospectively collected database was performed for the
period January 2002 to June 2013. Five hundred fifty patients underwent long-term central
venous catheter placement. All procedures were performed by experienced (>50 placements)
surgeons utilizing standard techniques.
Obtaining central venous access is a fundamental clinical skill for managing patients
in a wide variety of clinical situations. Success in this procedure requires knowledge
of patient’s anatomy, clinical condition, and comorbidities.
In addition, it also depends on the operator skills.
The role of routine portable ultrasound in the placement of Central Venous Catheters
has been debated.
compared to other puncture sites.1
However, for placing lines at the subclavian site, ultrasound is not very helpful.
Traditional infraclavicular SV catheterization is poorly amenable because of
the overlying clavicle, which can make visualization and direct
guidance difficult due to the acoustic shadow from the clavicle
and the usual SV anatomic position.
Emerg Med Open J. 2015; 1(4): 109-114. doi: 10.17140/EMOJ1-117
