Year: 2025 | Month: November | Volume: 15 | Issue: 11 | Pages: 182-191
DOI: https://doi.org/10.52403/ijhsr.20251123
Comparison of the Landmark Technique and the Static Ultrasound-Guided Technique for Subclavian Vein Cannulation in Adult Patients
Swayam Tara1, Deepika Phogat2, Vivek Anand3, Sunil Kumar Ganti4, Anand Naveen Chandran5, Mohammed Abdul Mateel6, Thulasidharan V P7
1,4,6Department of Anaesthesia, 2Department of Pathology, 3Department of Community Medicine, 5JDMS, 7Department of Orthopaedics,
1,2,4,6,7Military Hospital, Secunderabad, Andhra Pradesh, India.
3AIIMS, New Delhi, India
5JDMS, DGMS Army, New Delhi
Corresponding Author: Thulasidharan V P
ABSTRACT
Background: Role of ultrasound has been established in the central venous cannulation of Internal Jugular Vein but not in the cannulation of subclavian vein. This study aimed to determine whether static ultrasound guidance increases the efficiency and safety of subclavian vein catheterization in comparison to the landmark technique in a heterogeneous population at a tertiary care facility.
Methods: Patients receiving standard care were observed, with outcomes from those guided by the ultrasound (US) technique compared to those who underwent landmark (LM) technique and analyzed. In the landmark group, subclavian catheter insertion involved prepping the chest, injecting lidocaine, puncturing the vein, inserting a guide wire, followed by dilation and catheter threading and placement. In the US group, after standard preparation, ultrasound located the vein, marked its course, and pulse wave Doppler confirmed it. Catheterization followed without real-time guidance.
Results: Study included 113 participants, with 56 in the landmark group and 57 in US group. Baseline characteristics, including demographics, cannulation side, and urgency, were similar between groups. First-pass success rates were higher in US group, though not significantly different (p=0.248). Attempts for SV cannulation and time for cannulation showed no significant differences (p=0.47, p=0.193 respectively). No significant difference was observed in complication rates between the two techniques.
Conclusion: Static ultrasound-guided central venous catheterization of the SV showed similar first-pass success rates, attempts, and cannulation times to the conventional landmark-based technique. Complications such as arterial puncture, hematoma, and malposition were observed in both groups, but there was no statistically significant difference between the techniques.
Key words: Subclavian vein; Ultrasonography, interventional; Catheterization, Central Venous