The INVADE Study: INnominate Vein Approach for Central Catheterization in Difficult to cannulatE Patients
Central Venous Access in Patients With Difficult Cannulation, A Randomized Controlled Trial
Hospital Civil de Guadalajara
315 participants
Feb 27, 2024
INTERVENTIONAL
Conditions
Summary
Most recent guidelines suggest central venous access must be performed with real-time ultrasound guidance, and the most recommended site for cannulation is internal jugular vein (IJV); however, it is recognized that evidence for other sites is, at present, limited. Besides, guidelines does not account for patients with small vein cross-sectional area and/or respirophasic collapse, which can make the procedure more difficult or even impossible. The investigators aim to compare three different insertion sites for central venous access, with real-time ultrasound guidance
Eligibility
Inclusion Criteria1
- Patients who need central venous catheterization, and have respirophasic variation in cross-sectional area of jugular veins
Exclusion Criteria4
- Less than 18 years-old
- Patients with previous failed attempts with non-ultrasound guided technique
- Non-resolved pneumothorax/hemothorax at enrollment
- Refusal to sign informed consent
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Interventions
Catheterization of internal jugular vein with real-time (in-plane) method, with neutral neck position. Standard aseptic technique.
Catheterization of subclavian/axillary vein with infra-clavicular approach with real-time (in-plane) method, without shoulder retraction. Standard aseptic technique.
Catheterization of innominate vein with supra-clavicular approach with real-time (in-plane) method, with neutral shoulder position and no shoulder retraction. Standard aseptic technique.
Locations(1)
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NCT04265703