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Influence of caudal traction of ipsilateral arm on ultrasound image for supraclavicular central venous catheterization.

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Author(s)
Eun-Hee KimJi-Hyun LeeIn-Kyung SongHyun-Chang KimHee-Soo KimJin-Tae Kim
Keimyung Author(s)
Kim, Hyun Chang
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
American Journal of Emergency Medicine.
Issued Date
2016
Volume
34
Issue
5
Abstract
Background: The first step for successful ultrasound (US)–guided subclavian vein (SCV) catheterization using a
supraclavicular approach is to obtain a good longitudinal image of SCV for in-plane needle placement.We evaluated
the efficacy of caudal traction of ipsilateral arm on the exposure of the SCV.
Methods:Weenrolled 20 infants, 20 children, and 20 adults undergoing general anesthesia. After tracheal intubation,
US probe was applied as the supraclavicular approach, and the longitudinal US image of SCV was obtained in 3
different ipsilateral arm positions: neutral, caudal traction, and abduction. The length of puncturable SCV, the
diameter of SCV, and the available angle for needle insertion in 3 different arm positions were analyzed.
Results: In all patients, the length of puncturable SCV and the available angle for needle insertion were significantly
increased after caudal traction (35.6% ± 27.1% and 25.0% ± 19.3%, respectively) and decreased after the abduction
(36.6% ± 22.9% and 29.5% ± 23.8%, respectively) compared to neutral position. The diameter of SCV was not
changed after applying the caudal traction in infants and children. However, in adults, the caudal traction slightly
increased the diameter of SCV (P = .012).
Conclusion: The caudal traction of ipsilateral arm toward to the knee improves the longitudinal US view of SCV for
the supraclavicular approach, without reducing its size. Proper caudal traction of the arm might ensure the high
success rate with safe needle insertion technique. Abduction should be avoided during US-guided supraclavicular
SCV catheterization.
Keimyung Author(s)(Kor)
김현창
Publisher
School of Medicine
Citation
Eun-Hee Kim et al. (2016). Influence of caudal traction of ipsilateral arm on ultrasound image for supraclavicular central venous catheterization. American Journal of Emergency Medicine., 34(5), 851–855. doi: 10.1016/j.ajem.2016.01.038
Type
Article
ISSN
0735-6757
DOI
10.1016/j.ajem.2016.01.038
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33218
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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