- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT04674371
German Point Prevalence Study on CVC
German Point Prevalence Study on Central Venous Catheter
It has now been 90 years since Werner Forssmann developed the CVC. Nowadays CVCs play an integral role for critically ill patients.
Despite the high number of central venous access devices inserted annually, there are limited data on the incidence of the associated procedural complications, many of which carry substantial clinical risk. This point was highlighted in recently published Association of Anaesthetists of Great Britain and Ireland "Safe vascular access 2016" guidelines and "Clinical guidelines on central venous catheterisation" in 2014 of the Swedish Society of Anaesthesiology and Intensive Care Medicine.
This German point prevalence study should identify the number of central venous catheter insertions and the incidence of various and especially serious mechanical complications across multiple hospital sites within one day.
Secondary aims are to identify the availability of resources and infrastructure to facilitate safe central venous catheter insertion and management of potential complications.
As much hospital sites as possible should participate and identify all adult central venous catheter insertions, with subsequent review of any complications detected.
Additionally, resources while inserting the CVC should be specified such as ultrasound for assessment of ultrasound anatomy and/or ultrasound-guidance. Furthermore, assessment of the CVC tip should be studied whether done during CVC placement with
- ECG-guidance or by
- transthoracic/transesophageal ultrasound with the Microbubble test or more conventional post hoc with
- bedside chest X-ray Any mechanical complication should be documented untill day three post insertion. The background is to identify possible perforations due to initially unfavorable CVC tip positions (angle > 40 ° to wall of the superior vena cava).
Participation in the study is open to all disciplines (anesthesia, intensive care, internal medicine, surgery, etc.) that regularly perform CVCs.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Questions
- How experienced are the CVC operators?
- What are the demographics of the patients included?
- How many emergency patients will be included in the study?
- How is the distribution of the punctured vessels and that of the respective sides?
- How many puncture attempts are necessary to achieve a successful CVC placement and how often do problems with the Seldinger-wire occur?
How often is ultrasound used to place a CVC and if so,
- Only for Screening?
- Puncture under ultrasound view?
- What is the distribution between short and long axis view?
- What catheter types and which caliber in French are being inserted?
Catheter position control:
- by EKG-lead on Pmax or Pmax - x cm (withdroth)
- by means of transthoracic ultrasound and agitated NaCl solution
- by means of transesophageal echocardiography and NaCl solution
- by means of X-ray image
- other or missing position control
- Statement on the position of the CVC tip
- How common are CVC-malpositions and what is their distribution?
- Which complications occur within 72 h? Which measures do you require and how do they affect the respective patient?
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
-
-
-
Berlin-Mitte, Allemagne, 10117
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin e.V.
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Age
Inclusion criteria:
- Adults
- Young Adults
- Children
- Infants
- Neonates
Exclusion criteria:
- None
Procedures
Inclusion criteria:
- Elective central venous access procedures
- Emergency central venous access procedures
Exclusion criteria:
- None
Providers
Inclusion criteria:
- Anesthesiologists
- Internist
- Neurologist
- Surgeon
- Etc.
Exclusion criteria:
- None
Selection of catheter insertion site
- External jugular
- Internal jugular
- Subclavian
- Femoral
Complications
Inclusion criteria:
- Arterial cannulation/injury/cerebral embolization/hemorrhage
- Catheter or wire shearing or loss
- Lacerations of great vessels
- Exsanguination
- Hemo/pneumothorax; peritoneal hemorrhage
- Pneumothorax
- Tamponade
- Tracheal injury
- Air embolism
- Heart puncture (tamponade)
- Hemothorax
- Stroke
- Mortality
- Number of attempts at central line placement
- Failed insertion attempts
- Successful, nontraumatic procedure
- Wire, needle, catheter issues
Exclusion criteria:
- Infections or other complications not associated with central venous catheterization
- Mechanical injury or trauma not associated with central venous catheterization
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Modèles d'observation: Cohorte
- Perspectives temporelles: Éventuel
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Patients Demographics
Délai: 17.05.2022
|
All patients with a CVC Insertion on May 17th.
2022 in participating Hospitals independent of sex, age or BMI in kg/m^2 are eligible
|
17.05.2022
|
|
Complications and malpositions
Délai: 17.05.2022-20.05.2022
|
Which complications and malpositions occur within 72 h
|
17.05.2022-20.05.2022
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Percentage of the emergency procedure
Délai: 17.05.2022
|
How many emergency patients will be included in the study
|
17.05.2022
|
|
Distribution of the vessel sites und sides
Délai: 17.05.2022
|
distribution of the punctured vessels (external jugular, internal jugular, subclavian, femoral ) and that of the respective sides |
17.05.2022
|
|
Experience of the operator
Délai: 17.05.2022
|
Resident physician/ Specialist doctor
|
17.05.2022
|
|
Puncture attempts
Délai: 17.05.2022
|
How many puncture attempts are necessary to achieve a successful CVC
|
17.05.2022
|
|
Type and caliber of catheter
Délai: 17.05.2022
|
What catheter types and which caliber in French are being inserted
|
17.05.2022
|
|
Wire problems/issues
Délai: 17.05.2022
|
witch and how often do problems with the Seldinger-wire occur
|
17.05.2022
|
|
Ultrasound assistance
Délai: 17.05.2022
|
Screening / Online guidance / Short or long axis view
|
17.05.2022
|
|
CVC tip position
Délai: 17.05.2022
|
measures to ensure central venous catheter tip position (i.e.
CXR, ECG method and ultrasound)
|
17.05.2022
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chaise d'étude: Wolfram Schummer, MD, PhD, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin
Publications et liens utiles
Publications générales
- Schmidt GA, Blaivas M, Conrad SA, Corradi F, Koenig S, Lamperti M, Saugel B, Schummer W, Slama M. Ultrasound-guided vascular access in critical illness. Intensive Care Med. 2019 Apr;45(4):434-446. doi: 10.1007/s00134-019-05564-7. Epub 2019 Feb 18. Review.
- McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003 Mar 20;348(12):1123-33. doi: 10.1056/NEJMra011883. No abstract available.
- Schummer W, Sakka SG, Hüttemann E, Reinhart K, Schummer C. [Ultrasound guidance for placement control of central venous catheterization. Survey of 802 anesthesia departments for 2007 in Germany]. Anaesthesist. 2009 Jul;58(7):677-85. doi: 10.1007/s00101-009-1569-1. German.
- Frykholm P, Pikwer A, Hammarskjold F, Larsson AT, Lindgren S, Lindwall R, Taxbro K, Oberg F, Acosta S, Akeson J. Clinical guidelines on central venous catheterisation. Swedish Society of Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand. 2014 May;58(5):508-24. doi: 10.1111/aas.12295. Epub 2014 Mar 5.
- Coe AJ. AAGBI Safe vascular access guidelines I. Anaesthesia. 2016 Aug;71(8):985. doi: 10.1111/anae.13553.
- Bierman S. AAGBI safe vascular access guidelines II. Anaesthesia. 2016 Aug;71(8):985-6. doi: 10.1111/anae.13554.
- Lathey RK, Jackson RE, Bodenham A, Harper D, Patle V; Anaesthetic Audit and Research Matrix of Yorkshire (AARMY). A multicentre snapshot study of the incidence of serious procedural complications secondary to central venous catheterisation. Anaesthesia. 2017 Mar;72(3):328-334. doi: 10.1111/anae.13774. Epub 2016 Dec 16.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
- Cathéter veineux central
- ligne veineuse centrale
- Catheterization, Central Venous / access
- Catheterization, Central Venous / methods
- Catheterization, Central Venous / instrumentation
- Catheterization, Central Venous / adverse effects
- Placement of larger catheters
- Insertion of CVCs
- Complication of CVCs
- CVC misplacement
- Ultrasonography, Interventional / adverse effects
- Ultrasonography, Interventional / instrumentation
- Ultrasonography, Interventional / methods
- Electroctrocardiography, Radiography, Echocardiographie/ TEE
- Vascular Access Devices / standards
- Vascular Access Devices / trends
- Critical Illness / therapy
- Humains
- Adults, Adolescents
Autres numéros d'identification d'étude
- DRKS00016855
- U1111-1229-1554 (Identificateur de registre: World Health Organization [WHO] Registry Network)
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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