An Evaluation of Complications in Ultrasound-Guided Central Venous Catheter Insertion in the Emergency Department

• Published in: Turkish journal of emergency medicine 2014-06, Vol.14 (2), p.53-58
• Main Authors: OZAKIN, Engin, CAN, Rumeysa, ACAR, Nurdan, BALOGLU KAYA, Filiz, CEVİK, Arif Alper
• Format: Article
• Language: English
• Subjects: acil servis; Central venous catheter; emergency department; Original; Santral venöz katater; ultrason kılavuzluğu; ultrasound-guided
• ISSN: 2452-2473; 2452-2473
• DOI: 10.5505/1304.7361.2014.93275

In emergency departments, emergency physicians frequently have to perform central venous access. In cases where peripheral venous access is not possible, central venous access is required for dialysis, fulfillment of urgent fluid need, or central venous pressure measurement. This study was carried out to evaluate the emergence of complications in the process of and in the 15 days following the insertion of central venous catheter under ultrasound guidance in the emergency department. For this study, patients who presented to the emergency department over a period of eight months with an urgent need for central catheter were examined prospectively. Age, gender, and accompanying diseases of patients as well as the type, time, duration, and indication of the venous access were recorded. Furthermore, the amount of experience of the physician was taken into consideration. In the emergency department, physicians performed ultrasound-guided central venous catheter insertion for 74 patients (40 men and 34 women). For access, internal jugular vein was used in 65 (87.8%) patients, and femoral vein was used in 9 (12.2%) patients. The reason for access was urgent dialysis need in 55 (74.3%), CVP measurement in 3 (4.1%), fluid support due to severe hypovolemia in 6 (8.1%), and difficulty of peripheral venous access in 10 (13.5%) patients. None of the patients developed complications in the process of or after the insertion. Patients did not have infections related to the catheter in 15 days following the insertion. Central venous access is frequently required in emergency departments. The risk of complication is little if any in ultrasonographyguided access carried out under appropriate conditions. Acil servislerde acil tıp hekimlerince santral damar yolu işlemi sık uygulanır. Periferik damar yolu açılamadığı hallerde, diyaliz, acil sıvı ihtiyacı veya santral venöz basınç ölçümü gereken durumlarda hastalar için santral damar yolu gerekmektedir. Acil serviste, ultrasonografi (USG) kılavuzluğunda uygulanan acil santral venöz katater girişimi sürecinde ve uygulamayı takip eden 15 gün içerisinde komplikasyon varlığını değerlendirmek amacı ile bu çalışma yapıldı. Sekiz aylık sürede acil servise başvuran ve acil santral katater gereksinimi olan hastalar ileriye dönük olarak incelendi. Hastaların yaşı, cinsiyeti, eşlik eden hastalıkları ile tercih edilen girişimin yolu, saati, süresi ve endikasyonu kaydedildi. Ayrıca girişimi yapan hekimin çalışma yılı da değerlendirmeye dahi