Mechanical complications after central venous catheterisation in the ultrasound-guided era: a prospective multicentre cohort study.

Humans Male Catheterization, Central Venous / adverse effects Jugular Veins / diagnostic imaging Prospective Studies Ultrasonography, Interventional / methods Ultrasonography
central venous catheter femoral vein internal jugular vein mechanical complication subclavian vein ultrasound guidance

Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
12 2022
Historique:
received: 08 06 2022
revised: 15 08 2022
accepted: 31 08 2022
pubmed: 25 10 2022
medline: 23 11 2022
entrez: 24 10 2022
Statut: ppublish

Résumé

Limited data are available on the incidence of mechanical complications after ultrasound-guided central venous catheterisation. We aimed to determine the incidence of mechanical complications in hospitals where real-time ultrasound guidance is clinical practice for central venous access and to identify variables associated with mechanical complications. All central venous catheter insertions in patients ≥16 yr at four emergency care hospitals in Sweden from March 2, 2019 to December 31, 2020 were eligible for inclusion. Every insertion was monitored for complete documentation and occurrence of mechanical complications within 24 h after catheterisation. Multivariable logistic regression analyses were used to determine associations between predefined variables and mechanical complications. In total, 12 667 catheter insertions in 8586 patients were included. The incidence (95% confidence interval [CI]) of mechanical complications was 7.7% (7.3-8.2%), of which 0.4% (0.3-0.5%) were major complications. The multivariable analyses showed that patient BMI <20 kg m The incidence of major mechanical complications is low in hospitals where real-time ultrasound guidance is the standard of care for central venous access. Several variables independently associated with mechanical complications can be used for risk stratification before catheterisation procedures, which might further reduce complication rates. NCT03782324.

Sections du résumé

BACKGROUND
Limited data are available on the incidence of mechanical complications after ultrasound-guided central venous catheterisation. We aimed to determine the incidence of mechanical complications in hospitals where real-time ultrasound guidance is clinical practice for central venous access and to identify variables associated with mechanical complications.
METHODS
All central venous catheter insertions in patients ≥16 yr at four emergency care hospitals in Sweden from March 2, 2019 to December 31, 2020 were eligible for inclusion. Every insertion was monitored for complete documentation and occurrence of mechanical complications within 24 h after catheterisation. Multivariable logistic regression analyses were used to determine associations between predefined variables and mechanical complications.
RESULTS
In total, 12 667 catheter insertions in 8586 patients were included. The incidence (95% confidence interval [CI]) of mechanical complications was 7.7% (7.3-8.2%), of which 0.4% (0.3-0.5%) were major complications. The multivariable analyses showed that patient BMI <20 kg m
CONCLUSIONS
The incidence of major mechanical complications is low in hospitals where real-time ultrasound guidance is the standard of care for central venous access. Several variables independently associated with mechanical complications can be used for risk stratification before catheterisation procedures, which might further reduce complication rates.
CLINICAL TRIAL REGISTRATION
NCT03782324.

Identifiants

DOI: 10.1016/j.bja.2022.08.036 PMID: 36280461
pubmed: 36280461
pii: S0007-0912(22)00509-8
doi: 10.1016/j.bja.2022.08.036
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03782324']

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

843-850

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

Maria Adrian (M)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Cardiothoracic Surgery, Anaesthesia and Intensive Care, Skåne University Hospital, Lund, Sweden. Electronic address: maria.adrian@med.lu.se.

Ola Borgquist (O)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Cardiothoracic Surgery, Anaesthesia and Intensive Care, Skåne University Hospital, Lund, Sweden.

Tina Kröger (T)

Medical Faculty, Lund University, Lund, Sweden.

Erik Linné (E)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Anaesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.

Peter Bentzer (P)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Anaesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.

Martin Spångfors (M)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Anaesthesia and Intensive Care, Kristianstad Hospital, Kristianstad, Sweden.

Jonas Åkeson (J)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Intensive and Perioperative Care, Skåne University Hospital, Malmö, Sweden.

Anders Holmström (A)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Intensive and Perioperative Care, Skåne University Hospital, Malmö, Sweden.

Rikard Linnér (R)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Cardiothoracic Surgery, Anaesthesia and Intensive Care, Skåne University Hospital, Lund, Sweden.

Thomas Kander (T)

Anaesthesia and Intensive Care, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden; Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Mechanical complications after central venous...
questionsmedicales.fr › Techniques d'investigation › Cathétérisme › Cathétérisme veineux central › Mechanical complications after central venous...
questionsmedicales.fr › Système cardiovasculaire › Vaisseaux sanguins › Veines › Veines jugulaires › Mechanical complications after central venous...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Mechanical complications after central venous...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Échographie interventionnelle › Mechanical complications after central venous...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Échographie › Mechanical complications after central venous...