Ultrasound-guided Axillary Vein Catheterization in Trauma (UAVCT)

Ultrasound-guided Axillary Vein Catheterization in the Trauma Intensive Care Unit: A Single-Center Retrospective Study

It is very important to choose the best central venous catheterization route for trauma patients, the determinants that need to be considered comprehensively include coagulation dysfunction, fracture of the clavicle on the side of the puncture, and tracheotomy care. More importantly, whether it can used simultaneously for accurate volume and invasive hemodynamic monitoring. For the purpose of support of cardiopulmonary function, the ideal position of the catheter tip is vital with regard to an accurate CVP and hemodynamic monitoring. Cannulation of the axillary vein is ideal for patients with severe poly-trauma because it avoids the thoracic cavity, intercostal arteries, tracheostomy, and clavicle, and is prone to compression even if the artery is injured. At present, there is no systematic introduction of ultrasound-guided axillary vein catheterization in the trauma ICU in the literature. Since Oct 2021, the investigators have attempted to practice axillary vein catheterization for this crucial trauma population; unfortunately, the investigators have not know till now whether this procedure is associated with accurate tip placement and its safety should also be weighted. So it is necessary to summarize the relevant clinical data.

Study Overview

• Status: Recruiting
• Conditions: Multiple Trauma/Injuries
• Intervention / Treatment: Procedure: Ultrasound-guided axillary vein catheterization

• Study Type: Observational
• Enrollment (Estimated): 132

Contacts and Locations

• Study Contact: Name: Shou-Yin Jiang, PhD.; Phone Number: 86-15988854485; Email: jansoean@zju.edu.cn

Study Locations

• China
  • Zhejiang
    • Hangzhou, Zhejiang, China, 310009
      • Recruiting
      • 2 nd Affiliated Hospital, School of Medicine, Zhejiang University, China
      • Contact: Shou-Yin Jiang, PhD.; Phone Number: 86-15988854485; Email: jansoean@zju.edu.cn

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Our study do not consider limits on age, sex, or pregnant.

Description

Inclusion Criteria:

• Trauma patients admitted to TICU
• Receiving axillary vein catheterization during TICU stay

Exclusion Criteria:

• Without record of axillary vein catheterization
• Without imaging confirming （X-ray or chest CT） the location of catheter tip

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Accurate placement of the CVC catheter tip for measuring CVP or invasive hemodynamic monitoring	Placement of the CVC catheter tip between level of tracheal carina and within 2 cm downward is ideal for measuring CVP or invasive hemodynamic monitoring.	2021-10-1~2023-04-30

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Puncture complications after axillary vein catheterization	Pneumothorax, thrombus, artery injury, local infection, catheter-related infection	2021-10-1~2023-04-30
TICU mortality	Death rate during TICU stay	2021-10-1~2023-04-30
TICU length of stay	Time (d) spent during TICU therapy	2021-10-1~2023-04-30
Ventilator support	Duration of ventilator support during TICU stay	2021-10-1~2023-04-30
Thromboembolism events	Incidents of thromboembolism events after axillary vein catheterization during TICU stay	2021-10-1~2023-04-30

Collaborators and Investigators

• Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University
• Investigators: Principal Investigator: Shou-Yin Jiang, PhD., 2 nd Affiliated Hospital, School of Medicine, Zhejiang University, China

Publications and helpful links

General Publications

• Zhou J, Wu L, Zhang C, Wang J, Liu Y, Ping L. Ultrasound guided axillary vein catheterization versus subclavian vein cannulation with landmark technique: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2022 Oct 28;101(43):e31509. doi: 10.1097/MD.0000000000031509.
• Su Y, Hou JY, Ma GG, Hao GW, Luo JC, Yu SJ, Liu K, Zheng JL, Xue Y, Luo Z, Tu GW. Comparison of the proximal and distal approaches for axillary vein catheterization under ultrasound guidance (PANDA) in cardiac surgery patients susceptible to bleeding: a randomized controlled trial. Ann Intensive Care. 2020 Jul 8;10(1):90. doi: 10.1186/s13613-020-00703-6.
• He YZ, Zhong M, Wu W, Song JQ, Zhu DM. A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation by experienced operators. J Thorac Dis. 2017 Apr;9(4):1133-1139. doi: 10.21037/jtd.2017.03.137.
• Wang HY, Sheng RM, Gao YD, Wang XM, Zhao WB. Ultrasound-guided proximal versus distal axillary vein puncture in elderly patients: A randomized controlled trial. J Vasc Access. 2020 Nov;21(6):854-860. doi: 10.1177/1129729820904866. Epub 2020 Mar 1.

Study record dates

Study Major Dates

• Study Start (Actual): April 25, 2023
• Primary Completion (Estimated): July 31, 2023
• Study Completion (Estimated): December 31, 2023

Study Registration Dates

• First Submitted: May 2, 2023
• First Submitted That Met QC Criteria: May 31, 2023
• First Posted (Actual): June 9, 2023

Study Record Updates

• Last Update Posted (Actual): June 13, 2023
• Last Update Submitted That Met QC Criteria: June 12, 2023
• Last Verified: April 1, 2023

More Information

Terms related to this study

• Keywords: intensive care unit; complications; multiple trauma; axillary vein catheterization
• Additional Relevant MeSH Terms: Wounds and Injuries; Multiple Trauma
• Other Study ID Numbers: 2023-0364

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No