Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic Technology
Objective. One limitation of ultrasound-guided vascular access is the technical challenge of visualizing the cannula during insertion into the vessel. We hypothesized that the use of an echogenic vascular cannula (EC) would improve visualization when compared with a nonechogenic vascular cannula (NE...
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2012-01-01
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Online Access: | http://dx.doi.org/10.1155/2012/617149 |
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author | Konstantinos Stefanidis Mariantina Fragou Nicos Pentilas Gregorios Kouraklis Serafim Nanas Richard H. Savel Ariel L. Shiloh Michel Slama Dimitrios Karakitsos |
author_facet | Konstantinos Stefanidis Mariantina Fragou Nicos Pentilas Gregorios Kouraklis Serafim Nanas Richard H. Savel Ariel L. Shiloh Michel Slama Dimitrios Karakitsos |
author_sort | Konstantinos Stefanidis |
collection | DOAJ |
description | Objective. One limitation of ultrasound-guided vascular access is the technical challenge of visualizing the cannula during insertion into the vessel. We hypothesized that the use of an echogenic vascular cannula (EC) would improve visualization when compared with a nonechogenic vascular cannula (NEC) during real-time ultrasound-guided subclavian vein (SCV) cannulation in the ICU. Material and Methods. Eighty mechanically ventilated patients were prospectively enrolled in a randomized study that was conducted in a medical-surgical ICU. Forty patients underwent EC and 40 patients were randomized to NEC. The procedure was ultrasound-guided SCV cannulation via the infraclavicular approach on the longitudinal axis. Results. The EC group exhibited increased cannula visibility as compared to the NEC group (92%±3% versus 85±7%, resp., P<0.01). There was strong agreement between the procedure operators and independent observers (k=0.9, 95% confidence intervals assessed by bootstrap analysis = 0.87 to 0.93; P<0.01). Access time (12.1 s±6.5 versus 18.9 s±10.9) and the perceived technical difficulty of the ultrasound method (4.5±1.5 versus 7.5±1.5) were both decreased in the EC group compared to the NEC group (P<0.05). Conclusions. Echogenic technology significantly improved cannula visibility and decreased access time and technical complexity optimizing thus real-time ultrasound-guided SCV cannulation via a longitudinal approach. |
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institution | Kabale University |
issn | 2090-1305 2090-1313 |
language | English |
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series | Critical Care Research and Practice |
spelling | doaj-art-c020479b5e534bf68e3d5f605e7cb0892025-02-03T01:29:03ZengWileyCritical Care Research and Practice2090-13052090-13132012-01-01201210.1155/2012/617149617149Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic TechnologyKonstantinos Stefanidis0Mariantina Fragou1Nicos Pentilas2Gregorios Kouraklis3Serafim Nanas4Richard H. Savel5Ariel L. Shiloh6Michel Slama7Dimitrios Karakitsos8Radiology Department, Evangelismos University Hospital, 10676 Athens, GreeceIntensive Care Unit, General State Hospital of Athens, 11523 Athens, GreeceIntensive Care Unit, General State Hospital of Athens, 11523 Athens, GreeceSecond Department of Propedeutic Surgery, Faculty of Medicine, National and Kapodistrian University of Athens, and Laiko General Hospital, 11527 Athens, Greece1st Critical Care Department, Evangelismos University Hospital, 10676 Athens, GreeceJay B. Langner Critical Care Service, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USAJay B. Langner Critical Care Service, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USAIntensive Care Unit, CHU Sud Amiens, 80054 Paris Cedex 1, FranceIntensive Care Unit, General State Hospital of Athens, 11523 Athens, GreeceObjective. One limitation of ultrasound-guided vascular access is the technical challenge of visualizing the cannula during insertion into the vessel. We hypothesized that the use of an echogenic vascular cannula (EC) would improve visualization when compared with a nonechogenic vascular cannula (NEC) during real-time ultrasound-guided subclavian vein (SCV) cannulation in the ICU. Material and Methods. Eighty mechanically ventilated patients were prospectively enrolled in a randomized study that was conducted in a medical-surgical ICU. Forty patients underwent EC and 40 patients were randomized to NEC. The procedure was ultrasound-guided SCV cannulation via the infraclavicular approach on the longitudinal axis. Results. The EC group exhibited increased cannula visibility as compared to the NEC group (92%±3% versus 85±7%, resp., P<0.01). There was strong agreement between the procedure operators and independent observers (k=0.9, 95% confidence intervals assessed by bootstrap analysis = 0.87 to 0.93; P<0.01). Access time (12.1 s±6.5 versus 18.9 s±10.9) and the perceived technical difficulty of the ultrasound method (4.5±1.5 versus 7.5±1.5) were both decreased in the EC group compared to the NEC group (P<0.05). Conclusions. Echogenic technology significantly improved cannula visibility and decreased access time and technical complexity optimizing thus real-time ultrasound-guided SCV cannulation via a longitudinal approach.http://dx.doi.org/10.1155/2012/617149 |
spellingShingle | Konstantinos Stefanidis Mariantina Fragou Nicos Pentilas Gregorios Kouraklis Serafim Nanas Richard H. Savel Ariel L. Shiloh Michel Slama Dimitrios Karakitsos Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic Technology Critical Care Research and Practice |
title | Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic Technology |
title_full | Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic Technology |
title_fullStr | Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic Technology |
title_full_unstemmed | Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic Technology |
title_short | Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic Technology |
title_sort | optimization of cannula visibility during ultrasound guided subclavian vein catheterization via a longitudinal approach by implementing echogenic technology |
url | http://dx.doi.org/10.1155/2012/617149 |
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