Availability of ultrasound imaging of a guidewire parallel to the vein during internal jugular central venous catheter placement

Abstract

AbstractUltrasound verification of the guidewire traveling along the vein parallel to it and without any changes in angle has been recommended for prevention of inadvertent arterial catheterization during central venous catheter (CVC) placement. The aim of this study was to determine the availability of this parallel guidewire imaging during internal jugular CVC placement. Fifty-six adult patients undergoing cardiovascular surgery were included. The success rate of acquiring a parallel guidewire image was assessed. Logistic regression models and generalized additive models were used to identify the factors contributing to achieve parallel guidewire imaging. Among 56 patients in whom the guidewire was correctly positioned, the parallel guidewire image was acquired in 45 (80%) patients. Body mass index (crude odds ratio: 0.74 [95% confidence interval: 0.61–0.91]; p = 0.004) and distance from the puncture site to the clavicle (crude odds ratio: 1.32 [95% confidence interval: 1.11–1.58]; p = 0.002) were associated with successful depiction. The predicted probability of successful visualization was 96% (95% confidence interval: 82–99%) when the distance from the puncture site to the clavicle was 50 mm. The distance is a reliable predictor for successful visualization, and thus it should be considered when performing internal jugular CVC placement.