Skip Navigation
Skip to contents

ACC : Acute and Critical Care


Author index

Page Path
HOME > Issue > Author index
Insool Yoo 1 Article
How to Decrease the Malposition Rate of Central Venous Catheterization: Real-Time Ultrasound-Guided Reposition
Hongjoon Ahn, Gundong Kim, Byulnimhee Cho, Wonjoon Jeong, Yeonho You, Seung Ryu, Jinwoong Lee, Seungwhan Kim, Insool Yoo, Yongchul Cho
Korean J Crit Care Med. 2013;28(4):280-286.
  • 2,566 View
  • 40 Download
  • 3 Citations
AbstractAbstract PDF
The purpose of this retrospective and prospective study is to evaluate the efficiency of ultrasound (US) guidance as a method of decreasing the malposition rate of central venous catheterization (CVC) in the emergency department (ED).
We retrospectively enrolled 379 patients who underwent landmark-guided CVC (Group A) and prospectively enrolled 411 patients who underwent US-guided CVC (Group B) in the ED of a tertiary hospital. Malposition of the CVC tip is identified when the tip is not located in the superior vena cava (SVC). In Group B, we performed US-guided intravascular guide-wire repositioning and then confirmed the location of the CVC tip with chest radiography when the guide-wire was visible in any three other vessels rather than in the approached vessel. In the case of a guide-wire inserted into the right subclavian vein (SCV), the left SCV and both internal jugular veins (IJV) were referred to as the three other vessels. The two subject groups were compared in terms of the malposition rate using Fisher's exact test (significance = p < 0.05).
There were 38 malposition cases out of a total of 790 CVCs. The malposition rates of Groups A and B were 5.5% (21) and 4.1% (17), respectively, and no statistically significant difference in malposition rate between the two groups was found. In Group B, the malposition rate was decreased from 4.1% (17) to 1.2% (5) after the guide-wire was repositioned with US guidance, which led to a statistically significant difference in malposition rate (p < 0.01).
The authors concluded that repositioning the guide-wire with US guidance increased correct placement of central venous catheters toward the SVC.


Citations to this article as recorded by  
  • Safety and Feasibility of Ultrasound-guided Peripherally Inserted Central Catheterization for Chemo-Delivery
    Tak-Joong Song, Shin-Seok Yang, Woo-Sung Yoon
    Journal of Surgical Ultrasound.2019; 6(1): 14.     CrossRef
  • Single Center Experience of Ultrasonography-guided Bedside Procedures for Surgical Patients
    Dooreh Kim, Dae Hyun Cho, Yun Tae Jung, Jae Gil Lee
    Journal of Surgical Ultrasound.2018; 5(2): 61.     CrossRef
  • Direction of the J-Tip of the Guidewire to Decrease the Malposition Rate of an Internal Jugular Vein Catheter
    Byeong jun Ahn, Sung Uk Cho, Won Joon Jeong, Yeon Ho You, Seung Ryu, Jin Woong Lee, In Sool Yoo, Yong chul Cho
    The Korean Journal of Critical Care Medicine.2015; 30(4): 280.     CrossRef

ACC : Acute and Critical Care