Ultrasound-guided Axillary Vein Catheterization in Trauma

Study Overview
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Brief Summary
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It is very important to choose the best central venous catheterization route for trauma patients, the determinants that need to be considered comprehensively include coagulation dysfunction, fracture of the clavicle on the side of the puncture, and tracheotomy care. More importantly, whether it can used simultaneously for accurate volume and invasive hemodynamic monitoring. For the purpose of support of cardiopulmonary function, the ideal position of the catheter tip is vital with regard to an accurate CVP and hemodynamic monitoring. Cannulation of the axillary vein is ideal for patients with severe poly-trauma because it avoids the thoracic cavity, intercostal arteries, tracheostomy, and clavicle, and is prone to compression even if the artery is injured. At present, there is no systematic introduction of ultrasound-guided axillary vein catheterization in the trauma ICU in the literature. Since Oct 2021, the investigators have attempted to practice axillary vein catheterization for this crucial trauma population; unfortunately, the investigators have not know till now whether this procedure is associated with accurate tip placement and its safety should also be weighted. So it is necessary to summarize the relevant clinical data.

Official Title
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Ultrasound-guided Axillary Vein Catheterization in the Trauma Intensive Care Unit: A Single-Center Retrospective Study

Conditions
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Multiple Trauma/Injuries

Intervention / Treatment
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* Procedure: Ultrasound-guided axillary vein catheterization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Trauma patients admitted to TICU Receiving axillary vein catheterization during TICU stay Exclusion Criteria: Without record of axillary vein catheterization Without imaging confirming （X-ray or chest CT） the location of catheter tip

Ages Eligible for Study
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Minimum Age: 0 Years
Maximum Age: 100 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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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Ultrasound-guided axillary vein catheterization|All axillary vein catheterizations were performed according to standard central venous catheterization procedures, which were performed under ultrasound guidance at the bedside. Before the operation, patients were placed in a supine position with the upper limb placed in a natural position, and the ultrasound probe and wires were wrapped with a sterile protective sheath. Ultrasound pre-scanning the axillary artery and axillary vein, and pay attention to using the minimum pressure to control the ultrasound probe to avoid crushing the blood vessels. The operator holds the ultrasound probe and puncture needle to puncture the axillary vein under the guidance of ultrasound. After drawing out of the dark red blood, the guide wire was inserted and the puncture needle was withdrawn. The three-lumen CVC catheter was then inserted using the Seldinger technique.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accurate placement of the CVC catheter tip for measuring CVP or invasive hemodynamic monitoring | Placement of the CVC catheter tip between level of tracheal carina and within 2 cm downward is ideal for measuring CVP or invasive hemodynamic monitoring. | 2021-10-1 2023-04-30 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Puncture complications after axillary vein catheterization | Pneumothorax, thrombus, artery injury, local infection, catheter-related infection | 2021-10-1 2023-04-30 | 
| Thromboembolism events | Incidents of thromboembolism events after axillary vein catheterization during TICU stay | 2021-10-1 2023-04-30 | 
| TICU mortality | Death rate during TICU stay | 2021-10-1 2023-04-30 | 
| TICU length of stay | Time (d) spent during TICU therapy | 2021-10-1 2023-04-30 | 
| Ventilator support | Duration of ventilator support during TICU stay | 2021-10-1 2023-04-30 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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multiple trauma, axillary vein catheterization, intensive care unit, complications