Akademik Veri Yönetim Sistemi
Anestezi Dergisi, cilt.23, sa.1, ss.40-45, 2015 (Scopus)
Objective: Central vein catheterization enables the monitorisation of central venous pressure, management of fluid administration and aspiration of venous air embolus from the entrance of right atrium. Accurate positioning of the catheter tip is essential to avoide complications. ECG guidance is a well-known technique for this purpose. In this retrospective study, we reported 1017 catheterizations in respect to complications and the effectiveness. Methods: After the approval of Hacettepe University Non-Interventional Researches Ethics Commitee, the reports of1017 subclavian vein catheterisations done over a 9 years period (January 2004 to October 2013) in patients over 18, were retrospectively evaluated and research has been done on the matter if the experience of the person doing the application has an affect on the complications or not. Results: Between January 2004 and October 2013,1364 subclavian vein catheterizations were performed of which 178 were under 18 years old. One hundred and sixty-nine of them were not evaluated because of incomplete records. Nine hundred and sixty-two catheterizations were peiformed with endovascular electrocardiographic guidence. The overall complication rate was 4.91%. One patient had pneumothorax (0.09 %) and 5 patients had arterial puncture (0.5%). Six patients had catheter tip malpositions (0.58%). Amongst 109 of the patients no sign of arithmia was observed during the catheterisation. The average number of needle insertion for specialists is 1.19±0.52 and for the residents is 1.20±0.55 and the difference between them is not statistically significant (p=0.674). Amongst the specialists and residents, the ratio of catheterisation to be done by a more experienced staff is found to be statistically significant (p=0.007). Conclusion: Endovascular electrocardiogram is found effective for accurate positioning of subclavian vein catheter tip. Number of attempts and complications were independent of the experience of the performer. As the anesthesiologists' experience increases, the need to leave the catheterization to a more experienced one decreases.