Effects of practitioner's experience on the clinical performance of ultrasound-guided central venous catheterization: a randomized trial

Hyun-Kyu Yoon, Min Hur, Hyeyeon Cho, Young Hyun Jeong, Ho-Jin Lee, Seong-Mi Yang, Won Ho Kim, Hyun-Kyu Yoon, Min Hur, Hyeyeon Cho, Young Hyun Jeong, Ho-Jin Lee, Seong-Mi Yang, Won Ho Kim

Abstract

We investigated whether two needle insertion techniques for ultrasound-guided internal jugular vein (IJV) catheterization differ in the number of needling attempts and complication rate between inexperienced and experienced practitioners. A total of 308 patients requiring IJV catheterization were randomly assigned into one of four groups: IJV catheterization performed by inexperienced practitioners using either Seldinger (IE-S; n = 78) or modified Seldinger technique (IE-MS; n = 76) or IJV catheterization performed by experienced practitioners using either Seldinger (E-S; n = 78) or modified Seldinger technique (E-MS; n = 76). All catheterizations were performed under the real-time ultrasound guidance. The number of needling attempts was not significantly different between the two techniques within each experience group (between IE-S vs. IE-MS P = 0.550, between E-S and E-MS P = 0.834). Time to successful catheterization was significantly shorter in the E-S group compared to E-MS group (P < 0.001) while no significant difference between IE-S and IE-MS groups (P = 0.226). Complication rate was not significantly different between the two techniques within each experience group. Practitioner's experience did not significantly affect the clinical performance of needle insertion techniques during ultrasound-guided IJV catheterization except the time to successful catheterization. Regarding the number of needling attempts and complication rate, both techniques could be equally recommended regardless of practitioner's experience.Trial registration: clinicaltrials.gov (https://ichgcp.net/clinical-trials-registry/NCT03077802).

Conflict of interest statement

The authors declare no competing interests

Figures

Figure 1
Figure 1
CONSORT flow diagram of the study.

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