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Critical Care Research and Practice
Volume 2012, Article ID 617149, 6 pages
Research Article

Optimization of Cannula Visibility during Ultrasound-Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by Implementing Echogenic Technology

1Radiology Department, Evangelismos University Hospital, 10676 Athens, Greece
2Intensive Care Unit, General State Hospital of Athens, 11523 Athens, Greece
3Second Department of Propedeutic Surgery, Faculty of Medicine, National and Kapodistrian University of Athens, and Laiko General Hospital, 11527 Athens, Greece
41st Critical Care Department, Evangelismos University Hospital, 10676 Athens, Greece
5Jay B. Langner Critical Care Service, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
6Intensive Care Unit, CHU Sud Amiens, 80054 Paris Cedex 1, France
7Unité INSERM 1088, University Picardie Jules Vernes, Amiens, 80025 Paris, France

Received 13 February 2012; Accepted 1 March 2012

Academic Editor: Apostolos Papalois

Copyright © 2012 Konstantinos Stefanidis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. One limitation of ultrasound-guided vascular access is the technical challenge of visualizing the cannula during insertion into the vessel. We hypothesized that the use of an echogenic vascular cannula (EC) would improve visualization when compared with a nonechogenic vascular cannula (NEC) during real-time ultrasound-guided subclavian vein (SCV) cannulation in the ICU. Material and Methods. Eighty mechanically ventilated patients were prospectively enrolled in a randomized study that was conducted in a medical-surgical ICU. Forty patients underwent EC and 40 patients were randomized to NEC. The procedure was ultrasound-guided SCV cannulation via the infraclavicular approach on the longitudinal axis. Results. The EC group exhibited increased cannula visibility as compared to the NEC group ( versus , resp., ). There was strong agreement between the procedure operators and independent observers ( , 95% confidence intervals assessed by bootstrap analysis = 0.87 to 0.93; ). Access time ( versus ) and the perceived technical difficulty of the ultrasound method ( versus ) were both decreased in the EC group compared to the NEC group ( ). Conclusions. Echogenic technology significantly improved cannula visibility and decreased access time and technical complexity optimizing thus real-time ultrasound-guided SCV cannulation via a longitudinal approach.