A Survey on Success Rate and Complications of Sonographic Guided Central Venous Catheterization

Introduction & Central venous catheter insertion may cause morbidities and sometimes mortalities. Traditional catheter insertion is done on the basis of superficial guides, a technique which is abolished in developed countries, while CVC insertion can be carried out under the sonographic guide at patient’s bedside with least complications.In this survey, we used sonographic guide as the procedure and gathered accurate information about the needed number of venous punctures, and investigated the injuries and complications in the neighborhood of vein during catheter insertion. During this case - control study, 213 patients underwent the CVC insertion, of which 105 patients underwent sonographic guide and the remaining 108 patients did not go through it. All the procedures were done under local anesthesia and by a single surgeon. The effects of sonographic intervention on reducing the complications, success of catheter insertion and injuries to the neighboring tissues were analyzed. The data regarding the complications, the success of the procedure and injury to the adjacent structures were analyzed. Kolmogorov-Smirnov and Levin’s tests were used for checking normality and homogeneity, respectively. Chi-square and Fisher’s exact tests were used as appropriated. 129 males and 84 females, totally 213 patients, were enrolled in this clinical survey. In the sonographic group the rate of successful CVC insertion was 100 % (105 cases), and in the other one it was 88.95(90 cases). The number with more than one venous puncture was significantly higher in the non sonographic group compared to the sonographic one, 35.2 % (38 cases) vs 11.4 % (12 cases). Arterial puncture happened in 20 cases in non sonographic group (18.5%), and in 2 cases in the other one (1.9 %) with a meaningful statistical difference. In 9 cases of non sonographic group venous puncture was not achieved despite 3 times trial, they had it with the first sonographic procedure. Sonographic guidance in CVC insertion increases the rate of achievement, and of the same time reduce the number of punctures and injuries to the adjacent elements near the vein. So acquaintance with this procedure for CVC insertion (even as self-education) seems essential.