Evaluation of Central Venous Catheters Inserted in The Emergency Service

Year 2022, Volume: 4 Issue: 2, 52 - 55, 01.07.2022

Mehmet Kıy Ali Duman Selçuk Eren Çanakçı Yunus Emre Özlüer Mustafa Emin Serin Ayhan Aköz

https://doi.org/10.38175/phnx.1041291

Abstract

Objective
In our study, we evaluated central venous catheter procedures performed by Adnan Menderes University, Department of Emergency Medicine in the emergency room and emergency intensive care units. We planned to investigate performing central venous catheter application with ultrasound guidance and the rate of bleeding complications in patients using anticoagulants or antiplatelet.
Material and Method
Between 15.11.2018-15.10.2019, central venous catheter application was performed 178 cases over the age of 18 and non-pregnant were included. Research data were evaluated by using SPSS 21.0 statistics program.
Results
A Central venous catheter procedure was performed in 78.7% of the patients with ultrasound guidance. 36.5% of the patients had a history of anticoagulant or antiplatelet drug use. The most common complications in our patients were ventricular dysrhythmia and subcutaneous hematoma.
Conclusion
In conclusion, when looking at the relationship between gender, anticoagulant and/or antiplatelet drug use, preferred vein and ultrasound use during the procedure, and complication status, no statistically significant results were found.

Keywords

Central Venous Catheter, emergency medicine, Ultrasound

Supporting Institution

no

Acil Serviste Takılan Santral Venöz Kateterlerin Değerlendirilmesi

Abstract

Amaç
Çalışmamızda Adnan Menderes Üniversitesi Acil Tıp Anabilim Dalı tarafından acil servis ve acil yoğun bakım ünitelerinde yapılan santral venöz kateter işlemlerini değerlendirdik. Antikoagülan veya antiplatelet ilaç kullanan hastalarda ultrason eşliğinde santral venöz kateter uygulaması yapmayı ve kanama komplikasyon oranlarını araştırmayı planladık.
Gereç ve Yöntem
15.11.2018-15.10.2019 tarihleri arasında santral venöz kateter uygulaması yapılmış 18 yaş üstü ve gebe olmayan 178 olgu dahil edildi. Araştırma verileri SPSS 21.0 istatistik programı kullanılarak değerlendirilmiştir.
Bulgular
Hastaların %78,7'sine ultrason eşliğinde santral venöz kateter işlemi uygulandı. Hastaların %36.5'inde antikoagülan veya antitrombosit ilaç kullanım öyküsü vardı. Hastalarımızda en sık görülen komplikasyonlar ventriküler disritmi ve cilt altı hematomdu.
Sonuç
Sonuç olarak cinsiyet, antikoagülan ve/veya antitrombosit ilaç kullanımı, işlem sırasında tercih edilen damar ve ultrason kullanımı ile komplikasyon durumu arasındaki ilişkiye bakıldığında istatistiksel olarak anlamlı bir sonuç bulunamadı.

Keywords

acil servis, ultrason, santral venöz katater

References

• Ruesch S, Walder B, Tramèr MR. Complications of central venous catheters: internal jugular versus subclavian access--a systematic review. Crit Care Med 2002;30:454.
• Wyatt C. Vascular Access. In Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM eds. Emergency medicine: A comprehensive study guide in emergency medicine, 8th ed. North Carolina: Mc Graw-Hill; 2016. pp:198-209.
• Hall DP, Estcourt LJ, Doree C, Hopewell S, Trivella M, Walsh TS. Plasma transfusions prior to insertion of central lines for people with abnormal coagulation. Cochrane Database Syst Rev. 2016;9:CD011756.
• Bowdle A. Vascular complications of central venous catheter placement: evidence-based methods for prevention and treatment. J Cardiothorac Vasc Anesth. 2014;28:358.
• Mumtaz H, Williams V, Hauer-Jensen M, Rowe M, Henry-Tillman RS, Heaton K, et al. Central venous catheter placement in patients with disoders of hemostasis. Am J Surg. 2000;180:503.
• Doerfler ME, Kaufman B, Goldenberg AS. Central venous catheter placement in patients with disorders of hemostasis. Chest. 1996;110:185.
• Balls A, LoVecchio F, Kroeger A, Stapczynski JS, Mulrow M, Drachman D. Central Line Emergency Access Registry Investigators. Ultrasound guidance for central venous catheter placement: results from the Central Line Emergency Access Registry Database. Am J Emerg Med. 2010;28: 561-567.
• Milling TJ Jr, Rose J, Briggs WM, Birkhahn R, Gaeta TJ, Bove JJ, et al. Randomized, controlled clinical trial of point-of-care limited ultrasonography assistance of central venous cannulation: the Third Sonography Outcomes Assessment Program (SOAP-3) Trial. Crit Care Med. 2005;33:1764-1769.
• Leung J, Duffy M, Finckh A. Real-time ultrasonographically-guided internal jugular vein catheterization in the emergency department increases success rates and reduces complications: a randomized, prospective study. Ann Emerg Med. 2006;48(5):540-547.
• Martin MJ, Husain FA, Piesman M, Mullenix PS, Steele SR, Andersen CA, et al. Is routine ultrasound guidance for central line placement beneficial? A prospective analysis. Curr Surg. 2004;61:71-74.