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3 "catheterization, central venous"
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Original Article
Vascular Surgery
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
Korean J Crit Care Med. 2015;30(4):280-285.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.280
  • 5,869 View
  • 85 Download
  • 1 Crossref
AbstractAbstract PDF
Background
We hypothesized that the direction of the J-tip of the guidewire during insertion into the internal jugular vein (IJV) might determine its ultimate location. Methods: In this study, 300 patients between the ages of 18 and 99 years who required central venous catheterization via IJV in the emergency department enrolled for randomization. IVJ catheterization was successful in 285 of 300 patients. An independent operator randomly prefixed the direction of the J-tip of the guidewire to one of three directions. Based on the direction of the J-tip, patients were allocated into three groups: the J-tip medial-directed group (Group A), the lateral-directed group (Group B), or the downward-directed group (Group C). Postoperative chest radiography was performed on all patients in order to visualize the location of the catheter tip. A catheter is considered malpositioned if it is not located in the superior vena cava or right atrium. Results: Of the total malpositioned catheter tips (8 of 285; 2.8%), the majority (5 of 8; 62.5%) entered the contralateral subclavian vein, 2 (25.0%) were complicated by looping, and 1 (12.5%) entered the ipsilateral subclavian vein. According to the direction of the J-tip of the guidewire, the incidence of malpositioning of the catheter tip was 4 of 92 in Group A (4.3%), 4 of 96 in Group B (4.2%), and there were no malpositions in Group C. There were no significant differences among the three groups (p = 0.114). Conclusions: The direction of the J-tip of the guidewire had no statistically significant effect on incidence of malpositioned tips.

Citations

Citations to this article as recorded by  
  • Perioperative Echocardiography to Confirm Correct Central Venous Catheter Placement: A Case Report
    Parag Gharde, Sourangshu Sarkar, Kalpana Irpachi, Amol Kumar Bhoje, Bhavdeep Kaur, Sandeep Chauhan
    A&A Practice.2020; 14(10): e01291.     CrossRef
Case Report
Thoracic Surgery
A Rare Case of Massive Hemothorax due to Central Venous Catheterization Treated with Angiographic Stent Implantation
Jung-Min Bae
Korean J Crit Care Med. 2015;30(1):18-21.   Published online February 28, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.1.18
  • 8,733 View
  • 129 Download
AbstractAbstract PDF
In critically ill patients, centeral venous catheterization is a widely used procedure for fluid resuscitation, massive transfusion, total parenteral nutrition, central venous pressure monitoring and hemodialysis. However, many complications are associated with central venous catheterization. Among these complications, hemothorax is rare but fatal. We recently experienced a 32-year-old female diagnosed with hemothorax due to subclavian catheterization who was successfully treated with angiographic intervention. There are no absolute indications of surgery or interventional treatment in such cases. Multicenter studies and consensus are necessary to determine the proper treatment for hemothorax due to central venous catheterization. Angiographic treatment is rarely used for this uncommon complication of subclavian catheterization. We describe a rare case with a review of the literature.
Original Article
Emergency
Interruption of Chest Compression for Central Venous Catheterization during Cardiopulmonary Resuscitation
Yong Oh Kim, Hyun Soo Park
Korean J Crit Care Med. 2014;29(3):172-176.   Published online August 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.3.172
  • 9,126 View
  • 85 Download
  • 2 Crossref
AbstractAbstract PDF
BACKGROUND
Peripheral venous catheterization (PVC) is a less invasive and time consuming technique than central venous catheterization (CVC); however, for patients in circulatory collapse or receiving cardiopulmonary resuscitation (CPR), PVC cannot be achieved easily. CVC can provide not only a more effective administration route for medication, but also important hemodynamic information. Owing to the possibility of CPR interruptions and complications, CVC is recommended only after the failure of PVC. This observational study is aimed to evaluate the risks and benefits of CVC during CPR.
METHODS
This retrospective observational study was performed in the emergency department (ED) of a university hospital. Adult patients without a pulse on arrival were consecutively enrolled if subclavian CVC was performed at the beginning of CPR. Patients who already had an established intravenous route or had severe chest injuries on arrival were excluded. Closed-circuit television was used to evaluate the frequency of compression interruption. The incidence of iatrogenic pneumothorax, an acute mechanical complication associated with subclavian CVC, was investigated using chest X-ray after CPR.
RESULTS
During a 6-month period, 35 patients underwent CPR and 31 of these received subclavian CVC. Among the patients, one patient experienced iatrogenic pneumothorax (3.8%), and 13 CPR interruptions occurred in 10 subjects during subclavian CVC.
CONCLUSIONS
During CPR in 31 patients, one iatrogenic pneumothorax was caused by subclavian CVC, and CPR interruptions were observed in approximately 30% of cases.

Citations

Citations to this article as recorded by  
  • Comparison between internal jugular vein access using midline catheter and peripheral intravenous access during cardiopulmonary resuscitation in adults
    Hyun Seok Chai, Young-Min Kim, Gwan Jin Park, Sang Chul Kim, Hoon Kim, Seok Woo Lee, Hyeon Jeong Park, Ji Han Lee
    SAGE Open Medicine.2023; 11: 205031212311753.     CrossRef
  • Femoral venous oxygen saturation obtained during CPR predicts successful resuscitation in a pig model
    Mu Jin Kim, Kyung Woon Jeung, Byung Kook Lee, Sung Soo Choi, Sang Wook Park, Kyung Hwan Song, Sung Min Lee, Yong Il Min
    The American Journal of Emergency Medicine.2015; 33(7): 941.     CrossRef

ACC : Acute and Critical Care