The Brachiocephalic Vein as a Safe and Viable Alternative to Internal Jugular Vein for Central Venous Cannulation
BACKGROUND:Although many studies have compared success and complication rates for central line insertion sites with and without ultrasound, few have examined the use of the brachiocephalic vein for central venous access. The aim of this study was to describe the brachiocephalic vein as an alternativ...
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| Veröffentlicht in: | Anesthesia and analgesia 2018-07, Vol.127 (1), p.146-150 |
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| creator | Beccaria, Paolo Federico Silvetti, Simona Lembo, Rosalba Landoni, Giovanni Monti, Giacomo Zambon, Massimo Mamo, Daniela Zangrillo, Alberto |
| description | BACKGROUND:Although many studies have compared success and complication rates for central line insertion sites with and without ultrasound, few have examined the use of the brachiocephalic vein for central venous access. The aim of this study was to describe the brachiocephalic vein as an alternative site for elective ultrasound vascular cannulation in adults, and to compare it with the more commonly used internal jugular vein site in terms of procedural difficulties, first pass failure rate, overall failure rate, and safety.
METHODS:In this single-center, retrospective cohort study, clinical data from consecutive adult patients undergoing elective ultrasound-guided central venous catheterization of upper body were retrieved from the department database. All of these central venous catheters were requested by department team, none was positioned for surgery. Seven hundred nine patients underwent central venous catheterization via the internal jugular approach and 285 patients via the brachiocephalic route. Patients catheterized via the brachiocephalic vein approach were then compared with those catheterized via the internal jugular vein in terms of ease of catheterization, success rate, and complications. Differences between approaches were assessed by univariate analyses and multivariable analysis.
RESULTS:Overall, 994 patients underwent central venous catheterization. A total of 87% had a successful catheter implantation at the first attempt, 6.7% of insertions were difficult, 5.7% were complicated, and 3.4% failed. Procedural difficulty was more frequent with the internal jugular than with the brachiocephalic approach (odds ratio, 0.38; 95% confidence interval, 0.19–0.76; P = .007) after correction for potential confounders. Differences between groups in complication rate (6.3% vs 4.1%) or failure rate (3.4% vs 3.5%) were not significant.
CONCLUSIONS:Brachiocephalic cannulation is a reasonable alternative to ultrasound-guided internal jugular vein catheterization. |
| doi_str_mv | 10.1213/ANE.0000000000003357 |
| format | Article |
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METHODS:In this single-center, retrospective cohort study, clinical data from consecutive adult patients undergoing elective ultrasound-guided central venous catheterization of upper body were retrieved from the department database. All of these central venous catheters were requested by department team, none was positioned for surgery. Seven hundred nine patients underwent central venous catheterization via the internal jugular approach and 285 patients via the brachiocephalic route. Patients catheterized via the brachiocephalic vein approach were then compared with those catheterized via the internal jugular vein in terms of ease of catheterization, success rate, and complications. Differences between approaches were assessed by univariate analyses and multivariable analysis.
RESULTS:Overall, 994 patients underwent central venous catheterization. A total of 87% had a successful catheter implantation at the first attempt, 6.7% of insertions were difficult, 5.7% were complicated, and 3.4% failed. Procedural difficulty was more frequent with the internal jugular than with the brachiocephalic approach (odds ratio, 0.38; 95% confidence interval, 0.19–0.76; P = .007) after correction for potential confounders. Differences between groups in complication rate (6.3% vs 4.1%) or failure rate (3.4% vs 3.5%) were not significant.
CONCLUSIONS:Brachiocephalic cannulation is a reasonable alternative to ultrasound-guided internal jugular vein catheterization.</description><identifier>ISSN: 0003-2999</identifier><identifier>EISSN: 1526-7598</identifier><identifier>DOI: 10.1213/ANE.0000000000003357</identifier><identifier>PMID: 29683822</identifier><language>eng</language><publisher>United States: International Anesthesia Research Society</publisher><subject>Adult ; Aged ; Brachiocephalic Veins - diagnostic imaging ; Catheterization, Central Venous - adverse effects ; Catheterization, Central Venous - instrumentation ; Catheterization, Central Venous - methods ; Central Venous Catheters ; Databases, Factual ; Equipment Design ; Female ; Humans ; Jugular Veins ; Male ; Middle Aged ; Punctures ; Retrospective Studies ; Risk Factors ; Treatment Failure ; Ultrasonography, Interventional</subject><ispartof>Anesthesia and analgesia, 2018-07, Vol.127 (1), p.146-150</ispartof><rights>International Anesthesia Research Society</rights><rights>2018 International Anesthesia Research Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4477-4c9aaa227abbe25b2cf0fab91c8d221fb41b403abc53a5c875d0fa0f6a66a6a23</citedby><cites>FETCH-LOGICAL-c4477-4c9aaa227abbe25b2cf0fab91c8d221fb41b403abc53a5c875d0fa0f6a66a6a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf><![CDATA[$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&PDF=y&D=ovft&AN=00000539-201807000-00026$$EPDF$$P50$$Gwolterskluwer$$H]]></linktopdf><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00000539-201807000-00026$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,780,784,4609,27924,27925,64666,65461</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29683822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beccaria, Paolo Federico</creatorcontrib><creatorcontrib>Silvetti, Simona</creatorcontrib><creatorcontrib>Lembo, Rosalba</creatorcontrib><creatorcontrib>Landoni, Giovanni</creatorcontrib><creatorcontrib>Monti, Giacomo</creatorcontrib><creatorcontrib>Zambon, Massimo</creatorcontrib><creatorcontrib>Mamo, Daniela</creatorcontrib><creatorcontrib>Zangrillo, Alberto</creatorcontrib><title>The Brachiocephalic Vein as a Safe and Viable Alternative to Internal Jugular Vein for Central Venous Cannulation</title><title>Anesthesia and analgesia</title><addtitle>Anesth Analg</addtitle><description>BACKGROUND:Although many studies have compared success and complication rates for central line insertion sites with and without ultrasound, few have examined the use of the brachiocephalic vein for central venous access. The aim of this study was to describe the brachiocephalic vein as an alternative site for elective ultrasound vascular cannulation in adults, and to compare it with the more commonly used internal jugular vein site in terms of procedural difficulties, first pass failure rate, overall failure rate, and safety.
METHODS:In this single-center, retrospective cohort study, clinical data from consecutive adult patients undergoing elective ultrasound-guided central venous catheterization of upper body were retrieved from the department database. All of these central venous catheters were requested by department team, none was positioned for surgery. Seven hundred nine patients underwent central venous catheterization via the internal jugular approach and 285 patients via the brachiocephalic route. Patients catheterized via the brachiocephalic vein approach were then compared with those catheterized via the internal jugular vein in terms of ease of catheterization, success rate, and complications. Differences between approaches were assessed by univariate analyses and multivariable analysis.
RESULTS:Overall, 994 patients underwent central venous catheterization. A total of 87% had a successful catheter implantation at the first attempt, 6.7% of insertions were difficult, 5.7% were complicated, and 3.4% failed. Procedural difficulty was more frequent with the internal jugular than with the brachiocephalic approach (odds ratio, 0.38; 95% confidence interval, 0.19–0.76; P = .007) after correction for potential confounders. Differences between groups in complication rate (6.3% vs 4.1%) or failure rate (3.4% vs 3.5%) were not significant.
CONCLUSIONS:Brachiocephalic cannulation is a reasonable alternative to ultrasound-guided internal jugular vein catheterization.</description><subject>Adult</subject><subject>Aged</subject><subject>Brachiocephalic Veins - diagnostic imaging</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Catheterization, Central Venous - instrumentation</subject><subject>Catheterization, Central Venous - methods</subject><subject>Central Venous Catheters</subject><subject>Databases, Factual</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Humans</subject><subject>Jugular Veins</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Punctures</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Failure</subject><subject>Ultrasonography, Interventional</subject><issn>0003-2999</issn><issn>1526-7598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEFv1DAQhS0EokvhHyDkI5cUexwnznFZFVpU0UPLXqOxd0ICXmdrJ1T8-3q7BVU9gGVr9DzfG1uPsbdSnEiQ6sPy6-mJeLSU0vUztpAaqqLWjXnOFvvbApqmOWKvUvqRpRSmesmOoKmMMgALdnPdE_8Y0fXD6GjXox8cX9MQOCaO_Ao74hg2fD2g9cSXfqIYcBp-EZ9Gfh7upedf5u-zx3hwdmPkKwpTzI01hXFOfIUhZGAaxvCavejQJ3rzUI_Zt0-n16uz4uLy8_lqeVG4sqzronQNIgLUaC2BtuA60aFtpDMbANnZUtpSKLROK9TO1HqT-6KrsMobQR2z94e5uzjezJSmdjskR95joPylFoSSAiqhTUbLA-rimFKkrt3FYYvxdytFuw-7zWG3T8POtncPL8x2S5u_pj_pZsAcgNtxn1v66edbim1P6Kf-f7PLf1jvOa2aAoQ0os6iyAcqdQeE15tz</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Beccaria, Paolo Federico</creator><creator>Silvetti, Simona</creator><creator>Lembo, Rosalba</creator><creator>Landoni, Giovanni</creator><creator>Monti, Giacomo</creator><creator>Zambon, Massimo</creator><creator>Mamo, Daniela</creator><creator>Zangrillo, Alberto</creator><general>International Anesthesia Research Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180701</creationdate><title>The Brachiocephalic Vein as a Safe and Viable Alternative to Internal Jugular Vein for Central Venous Cannulation</title><author>Beccaria, Paolo Federico ; Silvetti, Simona ; Lembo, Rosalba ; Landoni, Giovanni ; Monti, Giacomo ; Zambon, Massimo ; Mamo, Daniela ; Zangrillo, Alberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4477-4c9aaa227abbe25b2cf0fab91c8d221fb41b403abc53a5c875d0fa0f6a66a6a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Brachiocephalic Veins - diagnostic imaging</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Catheterization, Central Venous - instrumentation</topic><topic>Catheterization, Central Venous - methods</topic><topic>Central Venous Catheters</topic><topic>Databases, Factual</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Humans</topic><topic>Jugular Veins</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Punctures</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Failure</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beccaria, Paolo Federico</creatorcontrib><creatorcontrib>Silvetti, Simona</creatorcontrib><creatorcontrib>Lembo, Rosalba</creatorcontrib><creatorcontrib>Landoni, Giovanni</creatorcontrib><creatorcontrib>Monti, Giacomo</creatorcontrib><creatorcontrib>Zambon, Massimo</creatorcontrib><creatorcontrib>Mamo, Daniela</creatorcontrib><creatorcontrib>Zangrillo, Alberto</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesia and analgesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beccaria, Paolo Federico</au><au>Silvetti, Simona</au><au>Lembo, Rosalba</au><au>Landoni, Giovanni</au><au>Monti, Giacomo</au><au>Zambon, Massimo</au><au>Mamo, Daniela</au><au>Zangrillo, Alberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Brachiocephalic Vein as a Safe and Viable Alternative to Internal Jugular Vein for Central Venous Cannulation</atitle><jtitle>Anesthesia and analgesia</jtitle><addtitle>Anesth Analg</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>127</volume><issue>1</issue><spage>146</spage><epage>150</epage><pages>146-150</pages><issn>0003-2999</issn><eissn>1526-7598</eissn><abstract>BACKGROUND:Although many studies have compared success and complication rates for central line insertion sites with and without ultrasound, few have examined the use of the brachiocephalic vein for central venous access. The aim of this study was to describe the brachiocephalic vein as an alternative site for elective ultrasound vascular cannulation in adults, and to compare it with the more commonly used internal jugular vein site in terms of procedural difficulties, first pass failure rate, overall failure rate, and safety.
METHODS:In this single-center, retrospective cohort study, clinical data from consecutive adult patients undergoing elective ultrasound-guided central venous catheterization of upper body were retrieved from the department database. All of these central venous catheters were requested by department team, none was positioned for surgery. Seven hundred nine patients underwent central venous catheterization via the internal jugular approach and 285 patients via the brachiocephalic route. Patients catheterized via the brachiocephalic vein approach were then compared with those catheterized via the internal jugular vein in terms of ease of catheterization, success rate, and complications. Differences between approaches were assessed by univariate analyses and multivariable analysis.
RESULTS:Overall, 994 patients underwent central venous catheterization. A total of 87% had a successful catheter implantation at the first attempt, 6.7% of insertions were difficult, 5.7% were complicated, and 3.4% failed. Procedural difficulty was more frequent with the internal jugular than with the brachiocephalic approach (odds ratio, 0.38; 95% confidence interval, 0.19–0.76; P = .007) after correction for potential confounders. Differences between groups in complication rate (6.3% vs 4.1%) or failure rate (3.4% vs 3.5%) were not significant.
CONCLUSIONS:Brachiocephalic cannulation is a reasonable alternative to ultrasound-guided internal jugular vein catheterization.</abstract><cop>United States</cop><pub>International Anesthesia Research Society</pub><pmid>29683822</pmid><doi>10.1213/ANE.0000000000003357</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Anesthesia and analgesia, 2018-07, Vol.127 (1), p.146-150 |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aged Brachiocephalic Veins - diagnostic imaging Catheterization, Central Venous - adverse effects Catheterization, Central Venous - instrumentation Catheterization, Central Venous - methods Central Venous Catheters Databases, Factual Equipment Design Female Humans Jugular Veins Male Middle Aged Punctures Retrospective Studies Risk Factors Treatment Failure Ultrasonography, Interventional |
| title | The Brachiocephalic Vein as a Safe and Viable Alternative to Internal Jugular Vein for Central Venous Cannulation |
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