Journal article
Obesity hinders ultrasound visualization of the subclavian vein: implications for central venous access
The journal of vascular access, v 13(2)
01 Apr 2012
PMID: 22266587
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: International policy statements from the US and the UK recommend real-time ultrasound guidance (USG) for placement of central venous catheters (CVCs) to improve patient safety. The evidence to support USG for the internal jugular (IJ) route is unequivocal; however, there is conflicting data on the effectiveness of USG in visualization of the subclavian vein (SCV). This study sought to determine whether body mass index (BMI) or clavicle shape affected SCV visualization with USG.
Methods: Forty-one emergency department patients were enrolled. Subject height and weight were recorded for BMI calculation. The clavicle shape was recorded as either flat or protuberant. USG was performed to identify the SCV vein in both the transverse and sagittal views. The ability to visualize the vein was rated on a three point rubric scale.
Results: One subject had an underweight BMI, 18 a normal BMI, 12 an overweight BMI, and 10 an obese BMI. The improvement in the odds ratio (OR) of the ability to see the SCV in subjects with a normal compared to overweight/obese BMI was statistically significant (transverse view unadjusted OR=18.0 (95% CI 3.21 - 100.94), P=.001 and adjusted for a flat clavicle OR=10.54 (95% CI 1.41 - 78.37), P=.021).
Conclusions: Higher BMI and the presence of a flat clavicle limit the ability to visualize the SCV. These findings may help account for why USG for placement of SCV CVCs is less utilized. However, patients with a low/normal BMI and protuberant clavicle may benefit from USG when attempting SCV CVCs.
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Details
- Title
- Obesity hinders ultrasound visualization of the subclavian vein: implications for central venous access
- Creators
- Todd M. McGrath - Drexel UniversityEric A. Farabaugh - Drexel UniversityMichael J. Pickett - Drexel UniversityDavid K. Wagner - Drexel UniversitySharon Griswold-Theodorson - Drexel University
- Publication Details
- The journal of vascular access, v 13(2)
- Publisher
- Sage
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- MD (Doctor of Medicine) Program
- Web of Science ID
- WOS:000309414500019
- Scopus ID
- 2-s2.0-84866731367
- Other Identifier
- 991019168655804721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Peripheral Vascular Disease