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Journal of The Korean Society of Emergency Medicine 2009;20(4): 409-414. |
| Ultrasonography Assisted Internal Jugular Central Vein Catheterization in the Emergency Department: Comparison of Methods |
| Dae Wook Lee, Ki Hwan Kim, Myung Gab Lee, Young Soon Cho, Ho Jung Kim, Hoon Lim |
| Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Korea. choyoungsoon@hanafos.com |
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| ABSTRACT |
PURPOSE:
The purpose of this study was to determine whether ultrasonography assisted internal jugular central venous catheterization by single operator or two-operator could improve the success rate and decrease the number of complications compared to the traditional landmark technique.
METHODS:
This study was a prospective, randomized, clinical trial conducted from July 2008 to February 2009 in an urban Korean teaching hospital. Patients requiring central venous access were randomized to 1 of the 3 insertion techniques (single-operator technique, two-operator technique, traditional landmark technique). The primary outcome measure was cannulation success. Additional outcome measures included number of attempts, access times, and complications.
RESULTS:
One hundred fourteen patients were enrolled. Thirty four of 37(91.9%) internal jugular vein catheters were successfully inserted by single-operator technique, 34 of 39(87.2%) by two-operator technique and 22 of 38(57.9%) by landmark technique. First attempt cannulation was successful in 28 of 34(82.4%) using single-operator technique, 26 of 34(76.9%) using two-operator technique and 9 of 22(40.9%) using landmark technique. The median start to venipuncture time was 138 seconds by single-operator technique, 170 seconds by two-operator technique and 329 seconds by landmark technique. There were 19 complications in the study, 15 in the landmark group, 2 in the singleoperator group, and 2 in the two-operator group.
CONCLUSION:
Real-time ultrasonography assisted internal jugular vein catheterization has an higher success rate, is less time consuming, and has a lower complication rate. The single-operator technique appears to be equivalent to the two-operator technique in success rate and procedure time. |
| Key words:
Central venous catheterization, Ultrasonography, Emergency department |
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