COMPARISON BETWEEN ANATOMICAL VERSUS ULTRASONOGRAPHIC INSERTION OF CENTRAL VENOUS LINE

Ultrasonographic Guided Central Venous line

Abstract

Objective: To compare complications of anatomical versus ultrasonographic insertion of central venous line.
Study Design: Randomized control trails.
Place and duration of study: Department of Critical Care Military Hospital Rawalpindi, from 1st January to 30 April 2011.
Methodology: One hundred patients were included in the study and divided into two groups: insertion with Anatomical Land mark Technique (ALT) and under Ultrasonography (USG) guidance. Data was collected on operator skill, technique and site of placement of central venous catheters (CVC) end results included number of attempts, successful insertion of central venous line and complications.
Result: A total of 100 patients were enrolled for the study, 50 each in ALT and USG group. The success rate was 92% in anatomical approach and 100% in USG method. Complications were observed in 12% cases in anatomical group and USG group did not show any complications.
Conclusion: Ultrasonography assistance reduces the complication rates, number of attempts as well as the failure rates with Internal Jugular Vein (IJV) cannulation. We advocate the use of USG to guide CVC insertion, particularly in the IJV, and it should become the pattern of care in intensive care in Pakistan.