Comparison of Axillary Versus Subclavian Vein Strategies for Central Venous Catheterization Under Continuous Ultrasound Guidance
Comparison of Axillary Versus Subclavian Vein Strategies for Central Venous Catheterization Under Continuous Ultrasound Guidance: a Prospective, Randomized, Non-inferiority Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The secondary objectives of this study are to compare the following between the two techniques:
- the success rate of the establishment of a central venous catheter
- the success rate of establishment of a central venous catheter at the first attempt at venipuncture
- for non-failures (eg, a catheter is placed in the first four trys), time to cannulation
- the presence / absence of the following complications:
- arterial puncture (yes / no)
- pneumothorax (yes / no)
- hemothorax (yes / no)
- hematoma (yes / no)
- nerve injury (yes / no)
- aberrant course (yes / no)
The reasons catheter placement failures will also be described.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Gard
-
Nîmes, Gard, France, 30029
- CHU de Nîmes - Hopital Universitaire Caremeau
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- The patient must have given his/her informed and signed consent
- The patient must be insured or beneficiary of a health insurance plan
- The patient is available for 24 hours of follow-up
- Patient requiring the establishment of a central venous catheter
Exclusion Criteria:
- The patient is in an exclusion period determined by a previous study
- The patient is under judicial protection, under tutorship or curatorship
- The patient refuses to sign the consent
- It is impossible to correctly inform the patient
- The patient is pregnant, parturient, or breastfeeding
- Patient has a body mass index < 15 or > 40
- Congenital or acquired anatomical deformity (radiation therapy, trauma, surgery) of the axillary and/or subclavian regions
- Bleeding disorder (platelets < 50,000, prothrombine < 50%, activated cephaline time > 2 times the control value)
- Severe hypoxemia defined by a ratio PaO2 / FIO2 < 100
- Infection of the puncture area
- Known thrombosis of the subclavian or axillary veins
- Scheduled length of hospitalization less than 24 hours
- Agitated or non-cooperative patient
- The patient has already been included in this study
- subclavian and axillary veins are not simultaneously echogenic on one or both sides (left and right).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Axillary strategy
The first two attempts at central venous catheterization will be performed via the distal approach (axillary vein).
The third and fourth attempts at central venous catheterization will be performed by the medial approach (subclavian vein).
|
The first two attempts at central venous catheterization will be performed via the distal approach (axillary vein).
The third and fourth attempts at central venous catheterization will be performed by the medial approach (subclavian vein).
The same puncture material/devices will be used in both arms of the study.
|
|
Active Comparator: Subclavian strategy
The first two attempts at central venous catheterization will be performed by the medial approach (subclavian vein).
The third and fourth attempts at central venous catheterization will be performed by the distal approach (axillary vein).
|
The first two attempts at central venous catheterization will be performed by the medial approach (subclavian vein).
The third and fourth attempts at central venous catheterization will be performed by the distal approach (axillary vein).
The same puncture material/devices will be used in both arms of the study.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Central venous catheter established within first 2 puncture attempts
Time Frame: approximately 3 minutes
|
yes/no
|
approximately 3 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Central venous catheter established upon first punction attempt
Time Frame: approximately 3 minutes
|
yes/no
|
approximately 3 minutes
|
|
Establishment of a central venous catheter
Time Frame: approximately 3 minutes
|
yes/no
|
approximately 3 minutes
|
|
The time necessary for the establishment of a central venous catheter
Time Frame: approximately 3 minutes
|
For non-failures (ie establishment of a central venous catheter within 4 puncture attempts), the number of minutes necessary for the establishment of a central venous catheter
|
approximately 3 minutes
|
|
The time necessary for the establishment of a central venous catheter
Time Frame: approximately 3 minutes
|
all cases, in minutes
|
approximately 3 minutes
|
|
presence/absence of complications
Time Frame: Day 1
|
arterial puncture (yes / no), pneumothorax (yes / no), hemothorax (yes / no), hematoma (yes / no), nerve injury (yes / no), aberrant course (yes / no)
|
Day 1
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jean Yves Lefrant, MD PhD, Centre Hospitalier Universitaire de Nîmes
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- LOCAL/2011/JYL-GB-01
- 2011-A01353-38 (Other Identifier: ANSM)
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