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.
調査の概要
詳細な説明
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?
研究の種類
入学 (実際)
連絡先と場所
研究場所
-
-
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Berlin-Mitte、ドイツ、10117
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin e.V.
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参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 観測モデル:コホート
- 時間の展望:見込みのある
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Patients Demographics
時間枠: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
時間枠:17.05.2022-20.05.2022
|
Which complications and malpositions occur within 72 h
|
17.05.2022-20.05.2022
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Percentage of the emergency procedure
時間枠:17.05.2022
|
How many emergency patients will be included in the study
|
17.05.2022
|
|
Distribution of the vessel sites und sides
時間枠: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
時間枠:17.05.2022
|
Resident physician/ Specialist doctor
|
17.05.2022
|
|
Puncture attempts
時間枠:17.05.2022
|
How many puncture attempts are necessary to achieve a successful CVC
|
17.05.2022
|
|
Type and caliber of catheter
時間枠:17.05.2022
|
What catheter types and which caliber in French are being inserted
|
17.05.2022
|
|
Wire problems/issues
時間枠:17.05.2022
|
witch and how often do problems with the Seldinger-wire occur
|
17.05.2022
|
|
Ultrasound assistance
時間枠:17.05.2022
|
Screening / Online guidance / Short or long axis view
|
17.05.2022
|
|
CVC tip position
時間枠:17.05.2022
|
measures to ensure central venous catheter tip position (i.e.
CXR, ECG method and ultrasound)
|
17.05.2022
|
協力者と研究者
捜査官
- スタディチェア:Wolfram Schummer, MD, PhD、Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin
出版物と役立つリンク
一般刊行物
- 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.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
- 中心静脈カテーテル
- 中心静脈線
- 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
- 人間
- Adults, Adolescents
その他の研究ID番号
- DRKS00016855
- U1111-1229-1554 (レジストリ識別子:World Health Organization [WHO] Registry Network)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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