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German Point Prevalence Study on CVC

7. august 2022 oppdatert av: Wolfram Schummer, MD, PhD

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.

Studieoversikt

Status

Fullført

Forhold

Detaljert beskrivelse

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,

    1. Only for Screening?
    2. 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:

    1. by EKG-lead on Pmax or Pmax - x cm (withdroth)
    2. by means of transthoracic ultrasound and agitated NaCl solution
    3. by means of transesophageal echocardiography and NaCl solution
    4. by means of X-ray image
    5. 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?

Studietype

Observasjonsmessig

Registrering (Faktiske)

537

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

      • Berlin-Mitte, Tyskland, 10117
        • Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin e.V.

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Sannsynlighetsprøve

Studiepopulasjon

Over 2000 patients in Germany

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Observasjonsmodeller: Kohort
  • Tidsperspektiver: Potensielle

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Patients Demographics
Tidsramme: 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
Tidsramme: 17.05.2022-20.05.2022
Which complications and malpositions occur within 72 h
17.05.2022-20.05.2022

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Percentage of the emergency procedure
Tidsramme: 17.05.2022
How many emergency patients will be included in the study
17.05.2022
Distribution of the vessel sites und sides
Tidsramme: 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
Tidsramme: 17.05.2022
Resident physician/ Specialist doctor
17.05.2022
Puncture attempts
Tidsramme: 17.05.2022
How many puncture attempts are necessary to achieve a successful CVC
17.05.2022
Type and caliber of catheter
Tidsramme: 17.05.2022
What catheter types and which caliber in French are being inserted
17.05.2022
Wire problems/issues
Tidsramme: 17.05.2022
witch and how often do problems with the Seldinger-wire occur
17.05.2022
Ultrasound assistance
Tidsramme: 17.05.2022
Screening / Online guidance / Short or long axis view
17.05.2022
CVC tip position
Tidsramme: 17.05.2022
measures to ensure central venous catheter tip position (i.e. CXR, ECG method and ultrasound)
17.05.2022

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Studiestol: Wolfram Schummer, MD, PhD, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

17. mai 2022

Primær fullføring (Faktiske)

20. mai 2022

Studiet fullført (Faktiske)

20. mai 2022

Datoer for studieregistrering

Først innsendt

13. desember 2020

Først innsendt som oppfylte QC-kriteriene

17. desember 2020

Først lagt ut (Faktiske)

19. desember 2020

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

10. august 2022

Siste oppdatering sendt inn som oppfylte QC-kriteriene

7. august 2022

Sist bekreftet

1. mai 2022

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

Nei

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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