Ultrasound-guided central vein cannulation in COVID positive patients in ICU

ABSTRACT

Introduction: Traditionally, central lines are put blindly using anatomical landmarks, which often result in complications, such as, difficulty in access, misplaced lines, pneumothorax, bleeding from inadvertent arterial punctures, etc. •Ultrasonography provides “real-time” imaging, i.e., the needle can be visualized entering the vein that may result in a less associated complication. Objectives: To perform a study regarded •Ease of cannulation. •Time consumed. Materials and methods: Twenty-five critical care patients at the intensive care units of SVP Hospital, Ahmedabad, who needed central venous cannulation, with informed written consent. Results: Out of 25 patients, all (100%) cannulated successfully. In only 1 patient, carotid artery was punctured and was cannulated in second attempt. •96% of patients are cannulated in the first attempt. •Complication rate is 4%. Discussions After three or more attempts at insertion, mechanical complications increase by six times compared with a single attempt. In the USG-guided approach, most patients are cannulated in the first attempt compared to a conventional method. In the USG technique, access time required is much less. In most patients where Trendelenburg's position may be difficult where USG comes like a gift. Conclusion: We came to the conclusion that the USG approach took less time, required less attempts, and had a lower incidence of complications for cannulation of the internal jugular vein as compared to a conventional method.