Saldaña FGE, González CJR, González GJ, Arana GS, Lozano RE, Salinas GF

Language: Spanish
References: 4
Page: 149-151
PDF size: 95.89 Kb.

ABSTRACT

Objective: To determine if positioning the patient with the aid of an interscapular roll is more efficacious and safer for the placement of a subclavian central venous catheter.
Setting: Third level health care hospital (Hospital Christus Muguerza Alta Especialidad).
Design: Clinical assay.
Statistical analysis: Relative risk and chi square with Yates correction.
Material and methods: We studied 59 patients, randomly assigned to two groups: 39 in the “without support” group and 20 in the “with support” group. The main variable was the success in the central venous approach, and the secondary variables were mortality and morbidity related with the procedure.
Results: The “without support” group had eight failures in reaching the venous approach, and there were two failures in the “with support” group. The relative risk was of 0.48 (CI 95%) and chi square yielded 0.43 (p = 0.001).
Conclusion: For a successful subclavian central venous approach there is no difference in the positioning of the patient with or without an interscapular roll.

REFERENCES

1. Espinoza De Los Monteros P-Tapia Jurado J. Accesos venosos y complicaciones en: Sigler Morales L, Castañeda Gaxiola R, Rish Fein L. Lesiones vasculares por iatrogenia; México D.F. El Manual Moderno, 2004: 101-116.

2. Biemans JM, Smeets L, Kelder JC, van Heesewijk JP, Moll FL, Teijink JA. Optimal patient position for catheterization of the subclavian vein: in the Trendelemburg position without a rolled towel between the shoulder blades. Ned Tijdschr Geneeskd 2007; 151: 243-247.

3. Rodriguez CJ, Bolanowski A, Patel K, Perdue P, Carter W, Lukisk JR. Classical positioning decreases the cross-sectional area of the subclavian vein. Am J Surg 2006; 192: 135-137.

4. Fortune JB, Feustel P. Effect of patient position on size and location of the subclavian vein for percutaneous puncture. Arch Surg 2003; 138: 996-1000.