To confirm that central venous catheters inserted in the basilic or cephalic veins and performed under ultrasound guidance at the patient’s bedside: 1) eliminates the complications of pneumothorax and hemothorax, 2) offers a higher success rate of insertion, 3)avoids transport to the Radiology Department, 4) can be performed by a non-radiologist, and 5) allows significant cost savings to the hospital.
894 consecutive patients in the critical care units referred to a Critical Care specialist for PICC placement between October 3, 2001 and March 23, 2004 were reviewed for success of insertion and immediate complications.
Venous access was successful in all patients (100%). The tip of the catheters were in the central veins in 874 patients (97.76%) 88 of which (9.84%) were in the internal jugular. In 32 patients larger triple lumen catheters were used because of need for more access or unstable condition. No patient was referred to the Radiology Department for failure of venous access. There were no major immediate complications.
Central venous catheter placed in the basilic and cephalic veins under ultrasound guidance performed at the patient’s bedside: 1) eliminates the complications of pneumothorax and hemothorax, 2) offers a very high success rate of insertion, 3) avoids transport of patients to the Radiology Department, 4) can be performed by a non-radiologist, 5) allows significant cost-savings to the hospital.
The availability of portable ultrasound machines has revolutionized central venous access. The easy accessibility of the basilic and cephalic veins under ultrasound guidance has made it possible to cannulate the central veins with ease and avoids the complications of pneumothorax and hemothorax. In critical care units where transport of critically ill patients to the Radiology Department carries high risk, performance of the procedure at the bedside is safer for the patient and less expensive to the hospital.
E.C. Casalmir, None.