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Trial registered on ANZCTR
Registration number
ACTRN12618000572268
Ethics application status
Approved
Date submitted
26/02/2018
Date registered
16/04/2018
Date last updated
12/10/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
A prospective study on assessing the efficiency of front to back oriented ultrasound probe placed on the side of the neck in adults patients who require internal jugular vein (IJV) catheterization to see the tip of the needle while puncturing the vein in reducing complications.
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Scientific title
A prospective study on efficiency of alternative technique “Anteroposterior short axis in-plane ultrasound guided Internal Jugular Vein cannulation” in adults requiring IJV catheterization
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Secondary ID [1]
294149
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None
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Universal Trial Number (UTN)
U1111-1209-2202
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Trial acronym
APSAX in-plane US Guided IJV cannulation
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Internal Jugular Vein cannulation
306774
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Critically ill patients
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Condition category
Condition code
Anaesthesiology
305870
305870
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
: Internal jugular vein (IJV) catheterization is done using standard Seldinger technique. Cannulation, that is puncturing the IJV with needle, is done under ultrasound guidance Conventional practice is to keep ultrasound probe across IJV on the anterior aspect of neck with marker facing medially to obtain short axis view and cannulation is done using out of plane technique where needle tip cannot be seen. In this new technique, short axis view of IJV is obtained by placing the ultrasound probe perpendicularly by the side of the neck anteroposteriorly with the marker facing anteriorly. Ultrasound machine shows cross sectional image of IJV and carotid artery where lateral aspect of neck is on the top of the image and anterior aspect of neck is to the left of the image. Then, the approximate distance between center of the IJV and lateral aspect of neck, that is top of the image, is calculated. This distance is used to mark the skin on the anterior aspect of neck from ultrasound probe. This is the needle entry point. The needle is passed, as in in-plane technique, perpendicular to the ultrasound beam and parallel to the ultrasound probe from the calculated entry point on the anterior aspect of the neck towards the center of the IJV. Needle can be seen moving towards IJV from the left of the image on the screen. The needle can be directed upwards on the screen by directing the needle laterally towards the probe and downwards by directing the needle medially away from the probe for finer adjustments. Once needle punctures the IJV, free aspiration of dark venous blood confirms the needle tip position. As needle entry is perpendicular, to direct the guide wire towards heart, tilt the needle tip towards foot. After threading the guide wire confirm its position using ultrasound before dilatation and catheterization. Entire procedure is done under standard aseptic precaution by doctors with at least one year experience in ultrasound guided IJV cannulation. Chest X-ray is taken after the procedure to confirm the position of the catheter.
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Intervention code [1]
300441
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Access time in seconds from starting of skin puncture to successful aspiration of venous blood using stop watch.
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Assessment method [1]
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Timepoint [1]
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Successful aspiration of venous blood in to syringe
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Primary outcome [2]
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Number of attempts, allow up to 5 attempts, but if unsuccessful, standard ultrasound guided technique is used for cannulation.
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Assessment method [2]
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Timepoint [2]
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Successful aspiration of venous blood in to syringe
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Primary outcome [3]
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Success rate assessed using data in the record sheet.
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Assessment method [3]
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Timepoint [3]
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Able to advance the guide wire by study technique and found inside the IJV by ultrasound scanning within 5 attempts
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Secondary outcome [1]
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Mechanical complications arising from the procedure like posterior venous wall puncture, carotid arterial puncture, hematoma, bleeding and pneumothorax will be documented
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Assessment method [1]
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Timepoint [1]
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24 hours post procedure
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Eligibility
Key inclusion criteria
All patients who require IJV catheterization
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Refusal to participate in this study, previous surgery at the site of insertion, infection at the site of insertion, clotting abnormalities, presence of thrombus within the jugular vein and abnormal anatomy.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
28/03/2018
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Date of last participant enrolment
Anticipated
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Actual
27/08/2018
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Date of last data collection
Anticipated
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Actual
29/08/2018
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Sample size
Target
50
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Accrual to date
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Final
75
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Recruitment outside Australia
Country [1]
9624
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Brunei Darussalam
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State/province [1]
9624
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Bandar Seri Begawan
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Funding & Sponsors
Funding source category [1]
298783
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Hospital
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Name [1]
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Raja Isteri Pengiran Anak Saleha Hospital
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Address [1]
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Jalan Putera Al-Muhtadee Billah,
Bandar Seri Begawan BA1712
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Country [1]
298783
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Brunei Darussalam
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Primary sponsor type
Individual
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Name
Ganapathi Aithal
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Address
Department of Anaesthesia
Raja Isteri Pengiran Anak Saleha Hospital,
Jalan Putera Al-Muhtadee Billah,
Bandar Seri Begawan BA1712
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Country
Brunei Darussalam
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Secondary sponsor category [1]
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None
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Name [1]
297966
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Address [1]
297966
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Country [1]
297966
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299729
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MEDICAL AND HEALTH RESEARCH AND ETHICS COMMITTEE
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Ethics committee address [1]
299729
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Executive Screening Suite, Baseline Level One, RIPAS Hospital Bandar Seri Begawan BA 1710
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Ethics committee country [1]
299729
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Brunei Darussalam
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Date submitted for ethics approval [1]
299729
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10/02/2018
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Approval date [1]
299729
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22/03/2018
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Ethics approval number [1]
299729
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MHREC/MOH/2018/2(1)
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Summary
Brief summary
This is a single centre, prospective, uncontrolled research involving patients requiring internal jugular vein catheterization for their optimal management in RIPAS Hospital. All patients requiring IJV catheterization are included in the study. Consent will taken from the patient or next of kin. Doctors with minimum one year experience in ultrasound guided IJV cannulation are given training by detailed explanation and observation of cannulation using new technique twice before allowing to do the IJV catheterization using new anteroposterior short axis in-plane ultrasound guided technique. Access time from starting of skin puncture to successful venous puncture will be measured using stop watch in seconds. Primary outcome measures are aspiration of venous blood in to syringe and number of attempts. Success rate is number of patients in whom able to pass guide wire successfully as confirmed by ultrasound. Any complications due to this technique are recorded.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Ganapathi Aithal
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Address
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Department of Anaesthesia
Raja Isteri Pengiran Anak Saleha Hospital,
Jalan Putera Al-Muhtadee Billah,
Bandar Seri Begawan BA1712
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Country
81394
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Brunei Darussalam
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Phone
81394
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+673 2 242424
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Fax
81394
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Email
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[email protected]
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Contact person for public queries
Name
81395
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Ganapathi Aithal
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Address
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Department of Anaesthesia
Raja Isteri Pengiran Anak Saleha Hospital,
Jalan Putera Al-Muhtadee Billah,
Bandar Seri Begawan BA1712
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Country
81395
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Brunei Darussalam
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Phone
81395
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+673 2 242424
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Fax
81395
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Email
81395
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[email protected]
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Contact person for scientific queries
Name
81396
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Ganapathi Aithal
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Address
81396
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Department of Anaesthesia
Raja Isteri Pengiran Anak Saleha Hospital,
Jalan Putera Al-Muhtadee Billah,
Bandar Seri Begawan BA1712
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Country
81396
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Brunei Darussalam
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Phone
81396
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+673 2 242424
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Fax
81396
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Email
81396
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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