Related Experiment Video
Updated: Apr 8, 2026
The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
[Ultrasound-guided central venous access in patients with uncorrected coagulopathy]
Géza Reusz1, Csilla Langer, Tibor Hevessy
1Központi Aneszteziológiai és Intenzív Betegellátó Osztály, Markhot Ferenc Kórház Eger, Széchenyi u. 27-29., 3300.
Insights
Routine correction of coagulopathy before ultrasound-guided central venous catheterization is not necessary in critically ill patients. This study found no bleeding complications in patients with uncorrected coagulopathy, suggesting a safer approach.
Area of Science:
- Critical Care Medicine
- Vascular Access Procedures
- Coagulation Disorders
Background:
- Correction of coagulopathy is standard before central venous catheterization.
- Routine correction is debated for ultrasound-guided procedures due to rare mechanical complications.
Purpose of the Study:
- To assess the safety of ultrasound-guided central venous access in critically ill patients with coagulopathy.
Main Methods:
- Retrospective study of ultrasound-guided central venous catheterizations (Feb 2011-Jan 2013).
- Coagulopathy defined by INR/APTT ratio >1.5, platelets <100 G/l, or anticoagulation/clopidogrel.
- Data from ultrasound register and patient records.
Main Results:
- 310 procedures performed; 134 patients (43.2%) had coagulopathy.
- Only 10 cases of coagulopathy were corrected prior to catheterization.
- No bleeding complications observed in uncorrected coagulopathy (0% complication rate).
Conclusions:
- Coagulopathy is prevalent in critically ill patients.
- Routine correction of coagulopathy before ultrasound-guided central venous catheterization appears unnecessary.
- This practice may enhance patient safety and resource allocation.
Introduction:
Correction of coagulopathy prior to central venous catheterization is a standard practice. Before ultrasound-guided procedures, routine correction of coagulopathy is controversial as mechanical complications are rare.
Aim:
To evaluate the safety of ultrasound-guided central venous access in critically ill patients with coagulopathy.
Method:
In this retrospective study the authors included all ultrasound-guided central venous catheterizations performed in their Intensive Care Unit between February 2011 and January 2013. They defined coagulopathy as INR or APTT ratio above 1.5, platelet count below 100 G/l, and anticoagulation or clopidogrel therapy. Data obtained from ultrasound register and patient records were used.
Results:
310 ultrasound-guided central venous catheterizations were performed. Coagulopathy was observed in 134 cases (43.2%) and corrected in 10 cases prior to catheterization. There were no bleeding complications (complication rate in uncorrected coagulopathy: 0%, 95% confidence interval: 0-3.0%).
Conclusions:
Coagulopathy is common in critically ill patients, but its routine correction prior to ultrasound-guided central venous catheterization seems unnecessary.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:30Venous Thrombosis IV: Nursing Management
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:26Cardiac Catheterization IV: Nursing Management
01:21Cardiac Catheterization II: Right Heart Catheterization
01:28Cardiac Catheterization I: Pre-Procedure Overview