Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Department of Anesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea.
Sci Rep. 2021 Mar 24;11(1):6726. doi: 10.1038/s41598-021-86322-y.
We investigated whether two needle insertion techniques for ultrasound-guided internal jugular vein (IJV) catheterization differ in the number of needling attempts and complication rate between inexperienced and experienced practitioners. A total of 308 patients requiring IJV catheterization were randomly assigned into one of four groups: IJV catheterization performed by inexperienced practitioners using either Seldinger (IE-S; n = 78) or modified Seldinger technique (IE-MS; n = 76) or IJV catheterization performed by experienced practitioners using either Seldinger (E-S; n = 78) or modified Seldinger technique (E-MS; n = 76). All catheterizations were performed under the real-time ultrasound guidance. The number of needling attempts was not significantly different between the two techniques within each experience group (between IE-S vs. IE-MS P = 0.550, between E-S and E-MS P = 0.834). Time to successful catheterization was significantly shorter in the E-S group compared to E-MS group (P < 0.001) while no significant difference between IE-S and IE-MS groups (P = 0.226). Complication rate was not significantly different between the two techniques within each experience group. Practitioner's experience did not significantly affect the clinical performance of needle insertion techniques during ultrasound-guided IJV catheterization except the time to successful catheterization. Regarding the number of needling attempts and complication rate, both techniques could be equally recommended regardless of practitioner's experience.Trial registration: clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT03077802).
我们研究了在经验丰富和缺乏经验的从业者中，两种超声引导下颈内静脉（IJV）置管的针插入技术在针刺次数和并发症发生率方面是否存在差异。总共 308 名需要 IJV 置管的患者被随机分为四组：经验不足的从业者使用 Seldinger 技术（IE-S；n=78）或改良 Seldinger 技术（IE-MS；n=76）进行 IJV 置管，经验丰富的从业者使用 Seldinger 技术（E-S；n=78）或改良 Seldinger 技术（E-MS；n=76）进行 IJV 置管。所有置管均在实时超声引导下进行。在每个经验组中，两种技术的针刺次数均无显著差异（IE-S 与 IE-MS 之间 P=0.550，E-S 与 E-MS 之间 P=0.834）。E-S 组的置管成功时间明显短于 E-MS 组（P<0.001），而 IE-S 组与 IE-MS 组之间无显著差异（P=0.226）。在每个经验组中，两种技术的并发症发生率均无显著差异。除了置管成功时间外，从业者的经验并未显著影响超声引导下 IJV 置管过程中针插入技术的临床性能。关于针刺次数和并发症发生率，无论从业者的经验如何，两种技术均可同等推荐。试验注册：clinicaltrials.gov（https://clinicaltrials.gov/ct2/show/NCT03077802）。
