Ultrasonographic guidance increased successful insertion of internal jugular vein catheter in the emergency department

摘要

Several previous studies have shown that ultrasonographically guidedncentral vein catheter (CVC) insertion has greater initial success andnfewer complications than traditional landmark-based insertion. Thenstudy by Leung and colleagues differed from other ED studies by limitingnthe procedure to the internal jugular approach, randomizing withnconcealed allocation, and using a sample size large enough to shownimportant differences. A weakness of this study was the use of fewnoperators (n = 13) for a large number of procedures (n = 130).nComplication rates did not differ between experienced (defined as ≥ 25nprevious CVC insertions) and inexperienced operators in either treatmentngroup, although the study lacked power to show small differences.nThe overall complication rate in the control group was highern(16.9%) than that often seen in the literature, but most complicationsnwere hematomas, which often require no further intervention (1).