Comparison of the proximal and distal approaches for axillary vein catheterization under ultrasound guidance (PANDA) in cardiac surgery patients susceptible to bleeding: a randomized controlled trial

摘要

Illustration of proximal axillary (left) and distal axillary (right) approaches. , Diagrammatic drawings of the anatomical views of proximal ( ) and distal ( ) approaches for ultrasound-guided axillary venous catheterization. , Ultrasound visualization of the guide wire in the proximal ( ) and distal ( ) axillary veins. , catheter in place secured to the skin in proximal ( ) and distal ( ) approaches. The inferior margins of the clavicle are drawn in and , where the mid-clavicular point and the medial and lateral one-third of the clavicle are marked. White arrows show the guide wire. Black asterisk indicates the anticipated skin puncture site of the distal approach and black triangle indicates the anticipated skin puncture site of the proximal approach. C, clavicle; depth, the distance between skin surface and the anterior wall of vein; diameter, anteroposterior diameter of the vein