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Article description

Summary:

This single-center randomized clinical trial studied the superiority of the ultrasound-guided supraclavicular brachiocephalic central venous catheterization to the jugular vein catheterization.

Conclusions:

The study included 86 intraoperative and intensive care patients. Forty-two patients were allocated to the needle-in-plane ultrasound brachiocephalic catheterization group, while 44 to the needle-out-of-plane technique internal jugular vein catheterization.

In the brachiocephalic vein group, the investigators used the syringe-free in-plane approach with a low-frequency endocavity micro convex probe while using the usual out-of-plane syringe aspiration technique in the internal jugular vein.

The investigators measured the ultrasonography identification duration, cannulation duration, number of cannulation attempts, and the ease of the procedure. They defined the ultrasonographic time as the time to identify the target vein and counted the cannulation time from skin puncture until the needle removal.

The average cannulation duration, the ease of cannulation score, and the success rate were similar in both groups. Canulation took 27.7 and 28 seconds in the Brachiocephalic and the Jugular technique, respectively. Despite taking 12 seconds to identify the Brachiocephalic vein versus 3 seconds in the jugular vein with a P-value < 0.001, it seems to be clinically insignificant.

Therefore, the authors concluded that the new supraclavicular brachiocephalic approach is a valid technique, similar to the usual out-of-plane internal jugular for central venous catheterization.