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Colegio de Medicina Interna de México.

2017, Number 3

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Med Int Mex 2017; 33 (3)

Effect of ultrasound in real time in the insertion of central venous catheter

Hernández-Castañeda B, Peña-Pérez CA

Language: Spanish
References: 28
Page: 323-334
PDF size: 446.87 Kb.


ABSTRACT

Background: The placement of central venous catheter (CVC) is an essential part in the management of patients in many clinical scenarios. Ultrasonography in real time (USRT) has become an invaluable tool because of its safety and availability and provides detailed information regarding the anatomy of the internal organs, in the placement of central venous catheters (CVCs) encouraging success rates and decreasing the number of complications.
Objetive: To determine whether the placement of central venous catheter guided by real-time ultrasound decreases the number of complications compared with the technique for anatomical references.
Material and Method: An observational, retrospective and prospective, longitudinal study was done selecting adults over 18 years old who required a CVC during their hospitalization at the Naval General Hospital of High Specialty (HOSGENAES), Mexico City, led by USRT and anatomical references from January 2014 to February 2016. Data were gathered from the files provided they were complete. The variables observed were the kind of complications, type of catheter insertion site, skilled operator, service that installed the CVCs, if it was first or subsequent, number of attempts, successful access and admission diagnoses, age, gender and body mass index (BMI).
Results: Four hundred sixty-four patients were included, of which 351 (76%) were guided by anatomical and 113 (24%) by USTR references. A total of 211 complications occurred; 84% in the group of anatomical references and 16% were reported in the group USTR with OR of 2.36. The most common complication was mainly mechanical type misplacement accounting for 51% in the group of anatomical references versus 12% in the USRT with OR of 9.5375. The 100% of CVCs guided by USTR were successful vs 87% guided by anatomical references.
Conclusions: Ultrasonography in real time improves success rates, reduces the number of attempts and reduces complications associated with the insertion of a central venous catheter.


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