Ultrasound guided axillary vein catheterization versus subclavian vein cannulation with landmark technique: A PRISMA-compliant systematic review and meta-analysis

Jinchuan Zhou, Lidong Wu, Chunquan Zhang, Jiwei Wang, Yanna Liu, Luyi Ping, Jinchuan Zhou, Lidong Wu, Chunquan Zhang, Jiwei Wang, Yanna Liu, Luyi Ping

Abstract

Background: Although ultrasound (US) guided axillary vein (AV) catheterization has been well described, evidence for its efficacy and safety compared with conventional infraclavicular landmark guided subclavian vein (SCV) cannulation have not been comprehensively appraised. Thus, we conducted a systematic review and meta-analysis to determine whether US guided AV catheterization reduces catheterization failures and adverse events compared to SCV puncture based on landmark technique.

Methods: We searched the PubMed, Embase, Cochrane Library, CINAHL, Web of Science, SCOPUS, China Biology Medicine, China National Knowledge Infrastructure, Wan Fang, and Wei Pu databases for randomized controlled trials (RCTs) studies published from inception to May 2021. Two investigators reviewed and extracted data on study design, number and type of inclusion criteria. Study quality was assessed using the Jadad scale. Outcomes included the puncture success rates and the incidence of adverse events.

Results: Data of 1852 patients from five RCTs were included in this meta-analysis. The analysis showed that US guided AV catheterization increased the first (risk ratio (RR), confidence interval (CI)) (RR = 1.17, 95% CI = 1.13~1.22, P < .01) and overall (RR = 1.09, 95% CI = 1.04~1.15, P < .01) puncture success rate, and reduce the occurrence of adverse events, including the risk of arterial puncture (RR = 0.18, 95% CI = 0.06~0.55, P < .01), pneumo-and hemothorax (RR = 0.12, 95% CI = 0.02~0.64, P = .01).

Conclusion: This meta-analysis indicates that US guided AV catheterization reduces catheterization failures and mechanical complications compared with conventional landmark guided SCV puncture.

Conflict of interest statement

The authors declare that they have no competing conflicts of interest related to this meta-analysis.

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1.
Figure 1.
Flowchart of study selection process.
Figure 2.
Figure 2.
Risk of bias graph: the authors’ judgments about each risk-of-bias item presented as percentages across all included studies.
Figure 3.
Figure 3.
Forest plot for first puncture success rate: 4 studies were included, I2 = 0%, fixed-effect model was adopted; the result showed an increased in the first puncture rate with the use of US guided AV catheterization.
Figure 4.
Figure 4.
Forest plot for overall puncture success rate: 3 studies were included, I2 = 0%, fixed-effect model was adopted; the result showed a increased in the overall puncture rate with the use of US guided AV catheterization.
Figure 5.
Figure 5.
Forest plot for arterial puncture: 4 studies were included, I2 = 18%, fixed-effect model was adopted; the result showed a reduction in the risk of artery puncture with the use of US guided AV catheterization.
Figure 6.
Figure 6.
Forest plot for pneumo-and hemothorax: 5 studies were included, I2 = 0%, fixed-effect model was adopted; the result showed reduction in the risk of pneumo-and hemothorax with the use of US guided AV catheterization.
Figure 7.
Figure 7.
Forest plot for hematoma: 2 studies were included, I2 = 0%, fixed-effect model was adopted; the result showed hematoma in the two group did not differ significantly.

References

    1. Smith RN, Nolan JP. Central venous catheters. BMJ. 2013;347:f6570.
    1. Brass P, Hellmich M, Kolodziej L, et al. . Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev. 2015;1:CD011447.
    1. O’Grady NP, Alexander M, Burns LA, et al. . Healthcare infection control practices advisory committee (HICPAC): guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52:e162–93.
    1. Schmidt GA, Blaivas M, Conrad SA, et al. . Ultrasound-guided vascular access in critical illness. Intensive Care Med. 2019;45:434–46.
    1. Sharma A, Bodenham AR, Mallick A. Ultrasound-guided infraclavicular axillary vein cannulation for central venous access. Br J Anaesth. 2004;93:188–92.
    1. Nickalls RW. A new percutaneous infraclavicular approach to the axillary vein. Anaesthesia. 1987;42:151–4.
    1. Bodenham A, Lamperti M. Ultrasound guided infraclavicular axillary vein cannulation, coming of age. Br J Anaesth. 2016;116:325–7.
    1. Czarnik T, Gawda R, Nowotarski J. Real-time ultrasound-guided infraclavicular axillary vein cannulation: a prospective study in mechanically ventilated critically ill patients. J Crit Care. 2016;33:32–7.
    1. García-Díaz MA, Ruiz-Castro M. Ultrasound guided infraclavicular axillary vein cannulation. Int J Clin Med. 2017;8:227–35.
    1. Moher D, Liberati A, Tetzlaff J, et al. . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Med. 2009;3:123–30.
    1. Jadad AR, Moore RA, Carroll D, et al. . Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials. 1996;17:1–12.
    1. Higgins JP, Altman DG, Gtzsche PC, et al. . The cochrane collaboration’s tool for assessing risk of bias in randomized trials. BMJ. 2011;343:d5928.
    1. Cui S, Wang J, Kang ZJ, et al. . Application of the ultrasound guided axillary vein catheterization in critically ill patients. Clin Med Eng. 2013;20:516–8.
    1. Kang FB, Dou WW, Niu J, et al. . Application effect of ultrasound-guided central vein catheterization through axillary vein in ICU ward. Clin Med Res Pract. 2020;5:93–4.
    1. Kim EH, Lee JH, Song IK, et al. . Real-time ultrasound-guided axillary vein cannulation in children: a randomised controlled trial. Anaesthesia. 2017;72:1516–22.
    1. Xu JX, Wang ZH, Ren H, et al. . Clinical application of ultrasound guided central venous catheterization via the axillary vein. Chin J Clin Nutr. 2013;21:163–7.
    1. Zheng QQ, Chai B, Lin WX, et al. . Clinical application of ultrasound-guided axillary vein catheterization with the second rib trajectory. J Qiqihar Med College. 2019;40:2395–7.
    1. Sterne JAC, Sutton AJ, Loannidis JPA, et al. . Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ. 2011;343:d4002.
    1. Frykholm P, Pikwer A, Hammarskjöld F, et al. . Clinical guidelines on central venous catheterisation. Swedish society of anaesthesiology and intensive care medicine. Acta Anaesthesiol Scand. 2014;58:508–24.
    1. Saugel B, Scheeren TWL, Teboul JL. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care. 2017;21:225.
    1. Hind D, Calvert N, McWilliams R, et al. . Ultrasonic locating devices for central venous cannulation: meta-analysis. BMJ. 2003;327:361.
    1. Wu SY, Ling Q, Cao LH, et al. . Real-time two-dimensional ultrasound guidance for central venous cannulation: a meta-analysis. Anesthesiology. 2013;118:361–75.
    1. Sandhu NS. Transpectoral ultrasound-guided catheterization of the axillary vein: an alternative to standard catheterization of the subclavian vein. Anesth Analg. 2004;99:183–7.
    1. Galloway S, Bodenham A. Ultrasound imaging of the axillary vein--anatomical basis for central venous access. Br J Anaesth. 2003;90:589–95.
    1. Belott P. How to access the axillary vein. Heart Rhythm. 2006;3:366–9.
    1. Timsit JF. Central venous access in intensive care unit patients: is the subclavian vein the royal route? Intensive Care Med. 2002;28:1006–8.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner