Resumen
Introducción: los accesos venosos centrales tienen mucha importancia en la práctica médica diaria. La inserción en la vena yugular es habitual debido a su accesibilidad. La trombosis venosa asociada a catéter es una complicación relativamente común y de mediano plazo. El empleo de la ecografía para guiar la inserción y la evaluación posterior del vaso sanguíneo ofrece múltiples ventajas y promete hacer de la instalación de accesos vasculares una técnica más segura.
Objetivo: comparar la proporción de trombosis yugular asociada a catéter cuando se emplea una técnica de referencias anatómicas con respecto a la técnica de guía ecográfica.
Material y métodos: estudio observacional, transversal y analítico que compara la frecuencia de trombosis yugular según la técnica de inserción utilizada en pacientes de una unidad de cuidados intensivos.
Resultados: se estudiaron un total de 91 pacientes: en 44 se utilizó una técnica de guía ecográfica y en 47 se empleó referencia anatómica. Se observó un solo caso de trombosis mural (2.7 %) en el grupo de inserción por guía ecográfica frente a 11 casos (23.4%) del grupo por referencias anatómicas, con lo cual se obtuvo como resultado una asociación significativa entre la técnica de inserción por referencia anatómica y trombosis. Chi cuadrada (1, n = 91) = 8.86, p = 0.004.
Conclusión: la proporción de trombosis yugular asociada a catéter es mayor cuando se emplea una técnica de referencias anatómicas con respecto a la técnica de guía ecográfica.
Abstract
Background: Central venous accesses are of great importance in daily medical practice. Insertion into the jugular vein is common due to its accessibility. Catheter-associated venous thrombosis is a relatively common medium-term complication. The use of ultrasound to guide catheterization offers multiple advantages and promises to make vascular access installation a safer technique.
Objective: To compare the proportion of catheter-associated jugular thrombosis when an anatomical landmark technique is used with respect to the ultrasound-guided technique.
Material and methods: An observational, cross-sectional, and analytical study that compares the frequency of thrombosis when the ultrasound-guided technique was used concerning anatomical reference technique in patients in an intensive care unit.
Results: A total of 91 patients were studied: in 44 an ultrasound-guided technique was used, and in 47 anatomical references. A single case of mural thrombosis (2.7%) was observed in the ultrasound-guided insertion group vs. 11 cases (23.4%) in the other group, resulting in a significant association between the anatomical reference insertion technique and thrombosis. Chi squared (1, n = 91) = 8.86, p = 0.004.
Conclusion: The proportion of catheter-associated jugular thrombosis is greater when an anatomical reference technique is used compared to the ultrasound-guided technique.
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