Catheterization of the internal jugular vein and subclavian/axillary vein under ultrasound control in the wounded with hemorrhagic shock due to combat trauma: a retrospective cohort study

Abstract

INTRODUCTION: Catheterization of central veins using ultrasound navigation increases the rate of successful catheterizations and reduces the number of complications. The use of ultrasound navigation can improve the efficiency and safety of catheterization in conditions where central vein puncture is difficult. OBJECTIVE: Comparison of the readiness of the internal jugular vein and the subclavian vein/axillary vein for puncture, the effectiveness and safety of their catheterization using ultrasound navigation in patients with hemorrhagic shock. MATERIALS AND METHODS: A retrospective study of the medical data of 146 victims who required puncture and catheterization of vessels under the control of ultrasound navigation was performed. In all victims, using ultrasound, the readiness of the vessels for puncture was visually assessed by the compression and collapse of the vein at the moment of slight superficial pressure with the sensor. RESULTS: Assessment of the vessel's readiness for catheterization showed that, at all degrees of shock, the readiness of the subclavian vein/axillary vein for catheterization was higher than that of the internal jugular vein. Analysis of all central venous catheterizations performed showed that they were completed on the first attempt, but during the attempt it was necessary to redirect, sometimes tighten and advance the needle again. The data obtained showed statistical differences in patients with II and III degrees of shock (p = 0.001). CONCLUSIONS: Against the background of infusion therapy through a peripheral venous catheter for all degrees of shock, readiness for puncture and catheterization of the subclavian vein/axillary vein was higher compared to the internal jugular vein. Such tactics for shocks of degree II and III result in fewer needle passes.