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Subclavian vein cannulation: an approach with definite landmarks
1Department of Anaesthesiology and Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
The Annals of Thoracic Surgery
|January 1, 1996
Summary
A new subclavian vein catheterization technique uses the coracoclavicular line as a landmark for precise needle guidance. This bedside approach achieved a 95.6% success rate on the first attempt in adult patients.
Area of Science:
- Medical procedures
- Anatomy
- Radiology
Background:
- Subclavian vein catheterization is a common medical procedure.
- Accurate landmark identification is crucial for successful and safe catheterization.
- Existing methods may have limitations in terms of accessibility or precision.
Purpose of the Study:
- To introduce and evaluate a novel subclavian vein catheterization technique.
- To utilize the coracoclavicular line as a consistent anatomical landmark.
- To improve the success rate and reduce complications of subclavian vein access.
Main Methods:
- Observation of the coracoclavicular line's parallelism to the subclavian vein catheter on chest roentgenograms.
- Patient positioning: supine, arm alongside body, 10-15 degree left shoulder elevation.
- Puncture point identification 1.5 cm from the clavicle's inferior border along the coracoclavicular line.
- Horizontal needle insertion following the coracoclavicular line's direction.
Main Results:
- The study involved 205 attempts in adult patients.
- A high success rate of 95.6% was achieved on the first cannulation attempt.
- No significant complications were reported during the procedure.
Conclusions:
- The described subclavian vein catheterization technique is promising.
- It relies on readily observable anatomical landmarks and a precise insertion direction.
- This method offers a potentially safer and more efficient approach to subclavian vein access.