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Supraclavicular Fossa US View for Catheter Positioning in Right Subclavian Central Venous Catheterization

NCT ID: NCT03812757

Last Updated: 2020-11-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-01-18

Study Completion Date

2020-01-01

Brief Summary

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The study will evaluate if the supraclavicular fossa ultrasound view can be used to achieve a correct catheter tip placement in infraclavicular right subclavian central venous catheter placement. This may make routine post-procedural x-ray exams redundant.

Detailed Description

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Central venous catheterization is one of the most common procedures within intensive care medicine. Verification of correct catheter tip placement is a primary aspect of safety and quality of central venous catheterization as malposition may lead to life-threatening complications such as thrombosis, hemothorax, cardiac tamponade, and arrhythmias. Conventional chest x-ray (CXR) is routinely performed after every insertion and is considered gold standard to examine catheter tip location and evaluate for complications such as pneumo- and hemothorax. However, CXR exposes the patient to ionized radiation, requires a considerable amount of time, and is workload-generating for both ICU and radiology staff.

Weber et al has described the use of the right supraclavicular fossa view for real-time ultrasound-guided placement of a central venous catheter (CVC) via the right internal jugular vein (IJV) in adults. This approach has subsequently been validated in a clinical study and has also been used for supraclavicular subclavian line insertion. The approach requires use of a microconvex probe, which couples good image resolution and high scanning depth. The use of a microconvex probe for infraclavicular subclavian central venous catheter (CVC) insertion has been described previously, but this is the first description of the supraclavicular fossa ultrasound view to guide correct catheter tip placement in infraclavicular right subclavian CVC placement.

Conditions

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Central Venous Catheter Placement

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Supraclavicular fossa US scanning

Following insertion of at least 20 cm of the guidewire into the right subclavian vein, the probe is shifted to the right supraclavicular fossa to scan the right internal jugular vein in order to exclude malposition of the guidewire. The probe is then tilted in a caudal direction to obtain a view of the guidewire within the superior vena cava. Misplaced guidewires will be corrected under real-time ultrasound guidance.

Supraclavicular fossa US scanning

Intervention Type DIAGNOSTIC_TEST

As previously stated.

Interventions

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Supraclavicular fossa US scanning

As previously stated.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Indication for central venous catheter placement.

Exclusion Criteria

* Operator unable to visualize the subclavian vein (e.g., in those with subcutaneous emphysema of the chest wall),
* Subclavian vein catheterization deemed inappropriate by the operator,
* Central line/pacemaker/similar device already in place (risk for misinterpretation of the ultrasound image)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Skane University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ola Borgquist

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ola Borgquist, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Skane University Hospital

Locations

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Skånes universitetssjukhus

Lund, , Sweden

Site Status

Countries

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Sweden

References

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Adrian M, Kander T, Lunden R, Borgquist O. The right supraclavicular fossa ultrasound view for correct catheter tip positioning in right subclavian vein catheterisation: a prospective observational study. Anaesthesia. 2022 Jan;77(1):66-72. doi: 10.1111/anae.15534. Epub 2021 Jul 14.

Reference Type DERIVED
PMID: 34260061 (View on PubMed)

Other Identifiers

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CVC positioning

Identifier Type: -

Identifier Source: org_study_id