Comparing short-, long-, and oblique-axis approaches to ultrasound-guided internal jugular venous catheterization: A meta-analysis of randomized controlled trials

doi:10.1097/TA.0000000000002158

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Title:	Comparing short-, long-, and oblique-axis approaches to ultrasound-guided internal jugular venous catheterization: A meta-analysis of randomized controlled trials
Authors:	Jen-Yin Chen(陳貞吟) Li-Kai Wang(王立楷) Yao-Tsung Lin(林耀聰) Kuo-Mao Lan(籃國懋) Loh, El-Wui Chen, Chih-Heng Tam, Ka-Wai
Contributors:	Chia Nan Univ Pharm & Sci, Dept Anesthesiol, Chi Mei Med Ctr Chia Nan Univ Pharm & Sci, Dept Senior Citizen Serv Management Natl Chung Hsing Univ, Dept Food Sci & Appl Biotechnol Taipei Med Univ, Shuang Ho Hosp, Ctr Evidence Based Hlth Care Taipei Med Univ, Shuang Ho Hosp, Dept Med Res Taipei Med Univ, Sch Med, Coll Med Taipei Med Univ, Sch Med, Coll Med, Div Gen Surg,Dept Surg Taipei Med Univ, Shuang Ho Hosp, Div Gen Surg, Dept Surg Taipei Med Univ, Cochrane Taiwan
Keywords:	Catheterization central venous internal jugular vein scanning axis ultrasonography meta-analysis
Date:	2019-03
Issue Date:	2020-07-29 13:48:53 (UTC+8)
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Abstract:	BACKGROUND: Internal jugular venous catheterization is performed for numerous therapeutic interventions. Although ultrasound-guided internal jugular venous catheterization is the gold standard for this procedure, complications can still occur. Various scanning axes, namely, the short axis (SA), long axis (LA), and oblique axis (OA), have been developed to ameliorate these complications. This study compared the efficacy and safety of SA, LA, and OA approaches. METHODS: PubMed, Embase, and Cochrane Library databases were searched for studies published before September 2018. Only randomized controlled trials were included. We conducted meta-analyses using a random-effects model. Treatment efficacy was measured by total success rate, first-pass success rate, number of needle passes, and incidence of complications, namely, arterial puncture, hematoma, and catheter-related bloodstream infection. RESULTS: Six randomized controlled trialswith 621 patients were included. No significant differenceswere observed in total success rate and first-pass success rate, as well as in the arterial puncture, hematoma, or catheter-related bloodstream infection complications between SA and LA approaches. Moreover, no significant difference was found between SA and OA approaches in terms of total success rate, first-pass success rate, number of needle passes, and complications of arterial puncture and hematoma. However, the number of needle passes was significantly fewer in SA approach than in LA approach (weighted mean difference, -0.18; 95% confidence interval, -0.35 to -0.01). CONCLUSION: None of the scanning axes exhibited unique features that could enhance their suitability for application. Hence, scanning axes should be selected by considering various factors that include patient characteristics, clinician expertise, and ease of procedures. Copyright (c) 2018 Wolters Kluwer Health, Inc. All rights reserved.
Relation:	Journal of Trauma and Acute Care Surgery, v.86, n.3, pp.516-523
Appears in Collections:	[Dept. of Senior Service and Health Management] Periodical Articles

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