An ultrasound-guided supraclavicular approach for tunneled central venous catheter insertion can be safely performed by junior residents

期刊论文
发表日期：

2024年7月23日

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Yumiko Iwamoto,
Shun Onishi,
Koshiro Sugita,
Kazuhiko Nakame,
Tatsuru Kaji,
Keisuke Yano,
Masato Ogata,
Lynne Takada,
Chihiro Kedoin,
Ayaka Nagano,
Masakazu Murakami,
Toshio Harumatsu,
Koji Yamada,
Waka Yamada,
Ryuta Masuya,
Takafumi Kawano,
Mitsuru Muto,
Satoshi Ieiri

摘要

Purpose

Ultrasound-guided supraclavicular catheterization (UGSC) of the brachiocephalic vein (BCV) for long-term tunneled central venous catheter (tCVC) insertion may be safer than the internal jugular vein approach due to its superior field of view. We examined the clinical outcomes of tCVC insertions performed by junior residents through UGSC of the BCV.

Patients and methods

From January 2018 to December 2023, we assessed clinical outcomes and compared the experience levels of surgeons conducting tCVC insertions. Surgeons were categorized into three groups: junior residency (JR), senior residency (SR), and board-certified pediatric surgeons (BCPS).

Results

177 tCVC insertions were done on 146 patients. Intraoperative complications included 6 cases of arterial puncture, 1 case of pneumothorax, 1 case of over insertion of catheter tip, and 1 case of suspected hemothorax. Distribution across groups was as follows: 28 cases (15.8%) in JR group, 92 (52.0%) in SR group, and 57 (32.2%) in BCPS group. Although the JR group exhibited longer operation times than the BCPS group, no significant differences in intraoperative complications were noted.

Conclusion

Junior residents can safely perform UGSC for tCVC insertion. However, careful consideration of complications such as arterial or thoracic puncture is essential and case selection should be based on experience.