A prospective randomised trial comparing insertion success rate and incidence of catheterisation-related complications for subclavian venous catheterisation using a thin-walled introducer needle or a catheter-over-needle technique.open access
- Authors
- Kim, Eugene; Kim, Byung-Gun; Lim, Young-Jin; Jeon, Young Tae; Hwang, Jeong Won; Kim, Hyun Chang; Choi, Yoon-Hyeon; Park, Hee-Pyoung
- Issue Date
- Sep-2016
- Publisher
- WILEY-BLACKWELL
- Keywords
- catheter-over-needle technique; complication; subclavian venous catheterisation; success rate; thin-walled introducer needle technique
- Citation
- ANAESTHESIA, v.71, no.9, pp.1030 - 1036
- Indexed
- SCIE
SCOPUS
- Journal Title
- ANAESTHESIA
- Volume
- 71
- Number
- 9
- Start Page
- 1030
- End Page
- 1036
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/153945
- DOI
- 10.1111/anae.13543
- ISSN
- 0003-2409
- Abstract
- In clinical practice, both a thin-walled introducer needle and catheter-over-needle technique can be used to allow insertion of a guidewire during central venous catheterisation using the Seldinger technique. We compared the incidence of catheterisation-related complications (arterial puncture, haemothorax, pneumothorax, haematoma and catheter tip malposition) and insertion success rate for these two techniques in patients requiring right-sided subclavian central venous catheterisation. A total of 414 patients requiring infraclavicular subclavian venous catheterisation were randomly allocated to either a thin-walled introducer needle (needle group, n = 208) or catheter-over-needle technique (catheter group, n = 206). The catheterisation-related complication rate was lower in the needle group compared with the catheter group (5.8% vs. 15.5%; p = 0.001). Overall insertion success rates were similar (97.1% and 92.7% in the needle and catheter groups respectively; p = 0.046), although the first-pass success rate was higher in the needle group (62.0% vs. 35.4%; p < 0.001). We recommend the use of a thin-walled introducer needle technique for right-sided infraclavicular subclavian venous catheterisation.
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