Medicina intensiva · 2025
The role of point-of-care ultrasonography in central venous catheter insertion: A randomized controlled trial of safety and cost-effectiveness.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Beniamen Ahmed, Mosallem Ahmed, Ali Hossam Tharwat, Nofal Hanaa A, Negm Essamedin M
Аннотация
OBJECTIVE: The objective of the study was to compare landmark-based and ultrasound-guided techniques of central venous catheter insertion (CVC).
DESIGN: Randomized controlled trial (2021-2023).
SETTING: Zagazig University Hospitals (ZUH), a tertiary care center.
PATIENTS: Adult patients in whom CVC insertion is indicated.
MAIN VARIABLES OF INTEREST: Demographic and clinical peri-procedural data, the safety of the technique, time of performance, and cost-effectiveness were compared.
RESULTS: Patient ages ranged from 17 to 80 years with 56% being males. Urgent indications were found in around 22% without significant differences between groups. Regarding the time of performance, the ultrasound-guided method had slightly but significantly less time of performance (25.7 ± 4.3; range: 18-33) compared to the blind technique (26.9 ± 7.4; range: 15-45) (P-value < 0.001) with a higher but non-significant number of patients without complications (64% vs 52%; P-value = 0.2). Failure to insert the CVC into the IJV occurred in 12 patients (12%) with the blind technique and in eight patients (8%) with the ultrasound-guided technique (P-value = 0.04). Carotid artery puncture with neck hematoma occurred in only 8 (8%) patients with the blind technique (P-value = 0.04). Excess cost was consumed in only 36 patients (36%) in the blind technique group (P-value = 0.001).
CONCLUSION: Point-of-care ultrasonography bundle for CVC insertion is considered superior to, safer, and more cost-effective than the blind technique.
DESIGN: Randomized controlled trial (2021-2023).
SETTING: Zagazig University Hospitals (ZUH), a tertiary care center.
PATIENTS: Adult patients in whom CVC insertion is indicated.
MAIN VARIABLES OF INTEREST: Demographic and clinical peri-procedural data, the safety of the technique, time of performance, and cost-effectiveness were compared.
RESULTS: Patient ages ranged from 17 to 80 years with 56% being males. Urgent indications were found in around 22% without significant differences between groups. Regarding the time of performance, the ultrasound-guided method had slightly but significantly less time of performance (25.7 ± 4.3; range: 18-33) compared to the blind technique (26.9 ± 7.4; range: 15-45) (P-value < 0.001) with a higher but non-significant number of patients without complications (64% vs 52%; P-value = 0.2). Failure to insert the CVC into the IJV occurred in 12 patients (12%) with the blind technique and in eight patients (8%) with the ultrasound-guided technique (P-value = 0.04). Carotid artery puncture with neck hematoma occurred in only 8 (8%) patients with the blind technique (P-value = 0.04). Excess cost was consumed in only 36 patients (36%) in the blind technique group (P-value = 0.001).
CONCLUSION: Point-of-care ultrasonography bundle for CVC insertion is considered superior to, safer, and more cost-effective than the blind technique.