The Use of Point of Care Ultra Sound for Correct Placement of Central Venous Catheter

Study Overview
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Brief Summary
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Central venous catheter (CVC) is an essential tool in the management of both medical and surgical patients. Establishing venous access is critically important and is sometimes technically challenging. Among the many indications for point of care ultrasound (POCUS), ultrasound-guided venous catheter placement is well described and increasingly used. This study was designed to evaluate the utility of peri procedural transthoracic echocardiography (TTE) as a tool for positioning CVC and for ruling out complications.

Detailed Description
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Central venous catheter (CVC) is an essential tool in the management of both medical and surgical patients. Establishing venous access is critically important and is sometimes technically challenging. Among the many indications for point of care ultrasound (POCUS), ultrasound-guided venous catheter placement is well described and increasingly used. This study was designed to evaluate the utility of peri procedural transthoracic echocardiography (TTE) as a tool for positioning CVC and for ruling out complications. The study population will be screened at the internal wards and medical intensive care unit of Soroka Medical Center. Research candidates' files will be screened routinely by a study coordinator. The study population will be enrolled according to the inclusion and exclusion criteria. The primary objective for the study is to evaluate whether the use of POCUS in CVC insertion can help inaccurate CVC tip placement, detect misplacement and complications and better than chest X ray.

Official Title
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The Use of Point of Care Ultra Sound for Correct Placement of Central Venous Catheter and for the Detection of Complications

Conditions
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Central Venous Catheter

Intervention / Treatment
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* Device: POC US


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients admitted to internal ward or medical intensive care unit Patients in need for central venous catheter in the subclavian or internal jugular veins Exclusion Criteria: Subject currently enrolled in another investigational study Surgical patients with open abdomen covered with bogota bag or vac - pac Patients with pneumothorax prior to central venous catheter insertion Patients in need for central venous catheter for hemodialysis

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Prospective implantation of POC US for CVC tip placement. | Device: POC US<br>* Use of point of care ultrasound in insertion of CVC<br>|
| No Intervention: Control<br>Retrospective data collection for CVC placement in the medical and surgical ICUs, before the initiation of the study and without the use of POCUS for CVC tip placement. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of misplacement of the tip of CVC. |  | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of ventricular arrhythmia during line insertion while using POC US |  | 6 months | 
| Duration time of CVC insertion using POC US |  | 6 months | 
| Number of CVC insertion complications using POC US |  | 6 months | 
| Sensitivity (score-the device's ability to identify a condition correctly) of POC US in detection of CVC insertion complications |  | 6 months | 
| Specificity (score-the device's ability to exclude a condition correctly) of POC US in detection of CVC insertion complications |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Central Venous Catheter, Point Of Care Ultra Sound, Sub Clavian Vein, Internal Jugular Vein, Trans Thoracic Echocardiography