Abstract
Despite their wide use, there's no consensus regarding the most efficient or safest method to insert long-term central lines. Basically, insertion can be accomplished by surgical cutdown approach or percutaneously and subclavian percutaneous venipuncture is historically the most popular route. Percutaneous approach to the internal jugular vein is generally considered less prone to severe complications, but data coming from large studies are mostly retrospective. Influence of surgical cutdown on late complications (e.g. venous thrombosis) is so far unknown. At least 14 trials addressed the issue of ultrasound guidance, and in 2002 the NICE (National Institute for Clinical Excellence - UK) produced the recommendation that 2-D imaging ultrasound guidance should be the preferred method when inserting of central venous catheter into the internal jugular vein in 'elective situations'. Aim of this paper is to critically review the available evidence about this topic, demonstrating that further randomised clinical trials of adequate statistic power are still needed to obtain an evidence-based consensus, possibly including differential costs, patients' compliance and satisfaction.
| Original language | English |
|---|---|
| Pages (from-to) | 75-80 |
| Number of pages | 6 |
| Journal | Nutritional Therapy and Metabolism |
| Volume | 24 |
| Issue number | 2 |
| Publication status | Published - Apr 2006 |
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Keywords
- Central venous catheters
- Chemotherapy
- Costs
- Quality of life assessment
- Total parenteral nutrition
- US guidance
ASJC Scopus subject areas
- Food Science
- Anatomy
- Critical Care and Intensive Care Medicine
- Nutrition and Dietetics
Cite this
Central venous long-term access : Are there new standards? / Biffi, Roberto.
In: Nutritional Therapy and Metabolism, Vol. 24, No. 2, 04.2006, p. 75-80.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Central venous long-term access
T2 - Are there new standards?
AU - Biffi, Roberto
PY - 2006/4
Y1 - 2006/4
N2 - Despite their wide use, there's no consensus regarding the most efficient or safest method to insert long-term central lines. Basically, insertion can be accomplished by surgical cutdown approach or percutaneously and subclavian percutaneous venipuncture is historically the most popular route. Percutaneous approach to the internal jugular vein is generally considered less prone to severe complications, but data coming from large studies are mostly retrospective. Influence of surgical cutdown on late complications (e.g. venous thrombosis) is so far unknown. At least 14 trials addressed the issue of ultrasound guidance, and in 2002 the NICE (National Institute for Clinical Excellence - UK) produced the recommendation that 2-D imaging ultrasound guidance should be the preferred method when inserting of central venous catheter into the internal jugular vein in 'elective situations'. Aim of this paper is to critically review the available evidence about this topic, demonstrating that further randomised clinical trials of adequate statistic power are still needed to obtain an evidence-based consensus, possibly including differential costs, patients' compliance and satisfaction.
AB - Despite their wide use, there's no consensus regarding the most efficient or safest method to insert long-term central lines. Basically, insertion can be accomplished by surgical cutdown approach or percutaneously and subclavian percutaneous venipuncture is historically the most popular route. Percutaneous approach to the internal jugular vein is generally considered less prone to severe complications, but data coming from large studies are mostly retrospective. Influence of surgical cutdown on late complications (e.g. venous thrombosis) is so far unknown. At least 14 trials addressed the issue of ultrasound guidance, and in 2002 the NICE (National Institute for Clinical Excellence - UK) produced the recommendation that 2-D imaging ultrasound guidance should be the preferred method when inserting of central venous catheter into the internal jugular vein in 'elective situations'. Aim of this paper is to critically review the available evidence about this topic, demonstrating that further randomised clinical trials of adequate statistic power are still needed to obtain an evidence-based consensus, possibly including differential costs, patients' compliance and satisfaction.
KW - Central venous catheters
KW - Chemotherapy
KW - Costs
KW - Quality of life assessment
KW - Total parenteral nutrition
KW - US guidance
UR - http://www.scopus.com/inward/record.url?scp=34250744656&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34250744656&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:34250744656
VL - 24
SP - 75
EP - 80
JO - Rivista Italiana di Nutrizione Parenterale ed Enterale
JF - Rivista Italiana di Nutrizione Parenterale ed Enterale
SN - 1828-6232
IS - 2
ER -