Ultrasonografi eşliğinde veya landmark yöntemiyle uygulanan, santral venöz kateter uygulamalarındaki başarı oranları ve oluşan komplikasyonların karşılaştırılması

Öz

Amaç: Genellikle yoğun bakımda kullanılan USG (ultrasonografi) ve Landmark yöntemleri ile santral venöz kateterizasyonlarda ortaya çıkabilecek başarı oranlarını ve komplikasyonları karşılaştırmaktır.

Materyal ve Metot: Bu çalışma geriye dönük olarak 100 hastanın dosyasını tarayarak gerçekleştirildi. Hastalar Ultrasonografi (n = 49) ve Landmark (n = 51) olmak üzere iki gruba ayrıldı. Dosyalardan elde edilen bilgilerle kateter çaplarının gruplara göre dağılımı, gruplara göre operasyonun hangi damardan yapıldığı, cinsiyete göre dağılımı ve oluşan komplikasyonlar karşılaştırıldı.

Bulgular: Çalışmamızda SVK (Santral Venöz Katater)'ler için kullanılan kateterlerin kalınlıklarının dağılımı gruplara göre farklılık göstermedi. Gruplarda cinsiyet dağılımı açısından bir değişiklik olmadı. SVK USG yöntemiyle 1 hastaya yapılamadı. USG yöntemiyle IJV (İnternal Juguler Ven) kateterizasyonunda 1 çoklu işlem denendi ve bu yöntem ile başka komplikasyon yaşanmadı.

Sonuç: USG yöntemi, SVK (SKV (subklavyen ven dışında)) uygulaması için YBÜ'de güvenilir, pratik ve uygulanabilir bir yöntemdir.

Anahtar Kelimeler

• Santral venöz kateterizasyon,Landmark yöntemi,ULTRASONOGRAFİ

A comparison of the rates of success and complications in the application of central venous catheters applied with ultrasonography or the landmark method

Öz

Background: To compare the rates of success and the complications that can develop during the central venous catheterizations with ultrasonography and Landmark methods, usually used in the intensive care unit.

Methods: This study was conducted retrospectively by scanning the files of 100 patients. Patients were divided into two groups as Ultrasonography (n=49) and Landmark (n=51). The distribution of the catheter diameters with the information obtained from the files based on groups, from which artery the operation was made based on the groups, the distribution of gender based on the groups, and the complications that occurred were compared.

Results: In our study, the distribution of the thickness of the catheters used for CVCs did not vary by group, there was no variation in terms of gender distribution in the groups, the CVC was not entered with the USG method, 1 multiple-operation was tried in the IJV catheterization with the USG method, and no other complications were experienced.

Conclusions: USG method is a reliable, practical, and applicable method in ICU for CVC (excepted SCV(subclavian vein) ) application.

Anahtar Kelimeler

• Central venous catheterization,Landmark method,Ultrasonography

Kaynakça

1. 1. De Jonge RC, Polderman KH, Gemke RJ. Central venous catheter use in the pediatric patient mechanical and infectious complications. Pediatr Crit Care Med. 2005;6:329- 39.
2. 2. Schexnayder SM, Storm EA, Stroud MH, Moss MM, Ross AS, et al. Pediatric Vascular Access and Centeses. In. Fuhrman BP, Zimmerman JJ (eds). Pediatric Critical Care. 4th ed. Philadelphia: Elsevier.2011;139-63.
3. 3. Moss M. Central venous catheter complications. Making headway. Pediatr Crit Care Med. 2012;13:694-5.
4. 4. Isgüder R, Gülfidan G, Agın H, Devrim İ, Kararslan U, et al. Central Venous Catheretization in Pediatric Intensive Care Unit: a four-years experience. Turk J Ped Em Int Care Med. 2014;1:31-38.
5. 5. Anıl AB, Anıl M, Kanar B, Yavaşcan Ö, Bal A, et al. The evaluation of central venous catheterization complications in a pediatric intensive care unit. Turk Arch Ped. 2011;46:215-9. (Abstract in English, Article in Turkish)
6. 6. Akyıldız B, Kondolot M, Akçakuş M, Poyrazoğlu H, Tunç A, ve ark. Çocuk yoğun bakım ünitesinde santral venöz kateterizasyon uygulanan hastalarımızın değerlendirilmesi: iki yıllık deneyimlerimiz. Turkish Pediatric Journal. 2009;52:63-67.
7. 7. Seldinger I. Catheter replacement of the needle in percutaneous arteriography: a new technique. Acta Radiologica. 1953 May 1; 39(5):368-376.
8. 8. Troianos CA, Hartman GS, Glas KE, Skubas NJ, Eberhardt RT, Walker JD, et al. Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. Journal of the American Society of Echocardiography. 2011; 24(12):1291-1318.

9. 9. Brass P, Hellmich , Kolodziej L, Schick G, Smith F. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev. 2015;(1).
10. 10. Bannon MP, Heller F, Rivera M. Anatomic considerations for central venous cannulation. Risk Manag Healthc Policy. 2011;4:27-39.
11. 11. Vincent JL, Bihari Ј, Suter М, Bruining А, White J, Nicolas-Chanoin MH, et al. The prevalence of nosocomial infection in intensive care units in Europe: results of the European Prevalence of Infection in Intensive Care (EPIC) Study. Jama. 1995;274(8):639-644. 12. Karakitsos D, Nikolaos L, De Groot E, Patrinakos AP, Gregorios K, John P, et al. Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Critical Care. 2006; 17;10(6):R162.
12. 13. Denys Bg, Uretsky BF, Reddy PS. Ultrasound-assisted cannulation of the internal jugular vein. A prospective comparison to the external landmark-guided technique. Circulation 1993;87:1557-62.
13. 14. Troianos c, Kuwik R, Pasqual J, lim A, odasso D. Internal jugular vein and carotid artery anatomic relation as determined by ultrasonography. Anesthesiology 1996;85:43-8.
14. 15.Ge X, Cavallazzi R, Li C, Pan SM, Wang YW, Wang FL. Central venous access sites for the prevention of venous thrombosis, stenosis and infection. Cochrane Database Syst Rev. 2012,14;3:CD004084.
15. 16.LeMaster CH, Schuur JD, Pandya D, Pallin DJ, Silvia J, Yokoe D, Agrawal A, Hou PC. Infection and natural history of emergency department-placed central venous catheters. Ann Emerg Med. 2010;56:492-7.
16. 17.Memon JI, Rehmani RS, Venter JL, Alaithan A, Ahsan I, Khan S. Central venous catheter practice in an adult intensive care setting in the eastern province of Saudi Arabia. Saudi Med J. 2010;31:803-7. 18.Paoletti F, Ripani U, Antonelli M, Nicoletta G. Central venous catheters. Observations on the implantation technique and its complications. Minerva Anestesiol. 2005; 71:555-60
17. 19. McGee DC, Gould MK. Preventing complications of central venous catheterization. New England Journal of Medicine. 2003; 348(12):1123-1133.
18. 20. Sznajder JL, Zveibil FR, Bitterman H, Weiner P, Bursztein SI. Central vein catheterization: failure and complication rates by 3 percutaneous approaches. Archives of Internal Medicine. 1986; 146(2):259-261.
19. 21. Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre , et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. Jama. 2001; 286(6):700-707.
20. 22. Prabhu V, Juneja , Palepu GB, Sathyanarayanan M, Subhramanyam , Gandhe S. Ultrasound-guided femoral dialysis access placement: a single-center randomized trial. Clinical Journal of the American Society of Nephrology. 2010; 5(2):235-239.
21. 23. Lefrant JY, Muller L, De La Coussaye JE, Prudhomme M, Ripart J, Gouzes C, et al. Risk factors of failure and immediate complication of subclavian vein catheterization in critically ill patients. Intensive care medicine. 2002;28(8):1036-1041.
22. 24. Matthew MЈ, Husain FА, Piesman M, Mullenix PS, Steele SR, Andersen CA, et al. Is routine ultrasound guidance for central line placement beneficial? A prospective analysis. Current surgery. 2004;61(1):71-74.
23. 25. Mansfild PF, Hohn CD, Fornage DB, Gregurich MA, Ota M. Complications and failures of subclavian-vein catheterization. New England Journal of Medicine. 1994; 331(26):1735-1738.
24. 26. Cronen MC, Cronen PW, Arino P, Ellis K. Delayed pneumothorax after subclavian vein catheterization and positive pressure ventilation. British journal of anaesthesia. 1991;67(4):480-482.
25. 27. Takeyama H, Taniguchi M, Sawai H, Funahashi H, Akamo Y, Suzuki S, et al. Limiting vein puncture to 3 needle passes in subclavian vein catheterization by the infraclavicular approach. Surgery today. 2006;36(9):779-782.
26. 28. Kilbourne MJ, Bochicchio GV, Scalea T, Xiao Y. Avoiding common technical errors in subclavian central venous catheter placement. Journal of the American College of Surgeons. 2009; 208(1):104-109.
27. 29.Breschan C, Platzer M, Likar R. Central venous catheter for newborns, infants and children. Anaesthesist. 2009;58:897-900,902-4.
28. 30.Adachi Y, Itagaki T, Suzuki K, Uchisaki S, Kimura K, Obata Y, Doi M, Sato S Masui. Multiple difficulties for central venous access required the distal femoral vein catheterization: a case report. 2009;58:913-6.
29. 31. Miller AH, Brett RA, Mills TJ, Woody R, Longmoor CE, Foster B. Ultrasound guidance versus the landmark technique for the placement of central venous catheters in the emergency department. Academic Emergency Medicine. 2002;9(8):800-805.
30. 32. Shah A, Smith A, Panchatsharam S. Ultrasound-guided subclavian venous catheterisation–is this the way forward? A narrative review. International journal of clinical practice. 2013; 67(8):726-732.
31. 33. Troianos CA, Jobes DR, Ellison N. Ultrasound-guided cannulation of the internal jugular vein. A prospective, randomized study. Anesthesia & Analgesia. 1991; 72(6):823-826.
32. 34. O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S; Healthcare Infection Control Practices Advisory Committee. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. Am J Infect Control 2011;39:1-34.