Clinical trial NCT05896735: Ultrasound-guided Axillary Vein Catheterization in Trauma
Official title: Ultrasound-guided Axillary Vein Catheterization in the Trauma Intensive Care Unit: A Single-Center Retrospective Study
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Multiple Trauma/Injuries
Keywords: multiple trauma
axillary vein catheterization
intensive care unit
complications
Lead sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University
Sponsor class: OTHER
First posted: 2023-06-09
Enrollment: 132
Sex: ALL
Minimum age (years): 0
Maximum age (years): 100
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Our study do not consider limits on age, sex, or pregnant.

Brief summary: 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.


Eligibility criteria: 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

Primary outcomes:
measure: Accurate placement of the CVC catheter tip for measuring CVP or invasive hemodynamic monitoring
timeFrame: 2021-10-1~2023-04-30
Secondary outcomes:
measure: Puncture complications after axillary vein catheterization
timeFrame: 2021-10-1~2023-04-30
measure: Thromboembolism events
timeFrame: 2021-10-1~2023-04-30
measure: TICU mortality
timeFrame: 2021-10-1~2023-04-30
measure: TICU length of stay
timeFrame: 2021-10-1~2023-04-30
measure: Ventilator support
timeFrame: 2021-10-1~2023-04-30
Other outcomes:
Locations:
city: Hangzhou
country: China
facility: 2 nd Affiliated Hospital, School of Medicine, Zhejiang University, China
state: Zhejiang
Study officials:
affiliation: 2 nd Affiliated Hospital, School of Medicine, Zhejiang University, China
name: Shou-Yin Jiang, PhD.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Zhou J, Wu L, Zhang C, Wang J, Liu Y, Ping L. Ultrasound guided axillary vein catheterization versus subclavian vein cannulation with landmark technique: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2022 Oct 28;101(43):e31509. doi: 10.1097/MD.0000000000031509.
citation: Su Y, Hou JY, Ma GG, Hao GW, Luo JC, Yu SJ, Liu K, Zheng JL, Xue Y, Luo Z, Tu GW. Comparison of the proximal and distal approaches for axillary vein catheterization under ultrasound guidance (PANDA) in cardiac surgery patients susceptible to bleeding: a randomized controlled trial. Ann Intensive Care. 2020 Jul 8;10(1):90. doi: 10.1186/s13613-020-00703-6.
citation: He YZ, Zhong M, Wu W, Song JQ, Zhu DM. A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation by experienced operators. J Thorac Dis. 2017 Apr;9(4):1133-1139. doi: 10.21037/jtd.2017.03.137.
citation: Wang HY, Sheng RM, Gao YD, Wang XM, Zhao WB. Ultrasound-guided proximal versus distal axillary vein puncture in elderly patients: A randomized controlled trial. J Vasc Access. 2020 Nov;21(6):854-860. doi: 10.1177/1129729820904866. Epub 2020 Mar 1.