Inserting central venous catheter in emergency conditions in coagulopathic patients in comparison to noncoagulopathic patients

Abstract

Background: The current study was designed to compare the complications and adverse eff ects of central venous catheter (CVC) insertion under ultrasound guidance in patients with and without coagulopathy. Materials and Methods: In this clinical trial,59 patients who needed CVC for various reasons were enrolled. Patients were divided into two groups of those with and without coagulopathy based on complete blood count, prothrombin time, partial thromboplastin time, and international normalized ratio test results, and then, CVC was inserted with ultrasound guidance in both groups. Th e CVC inserting site was examined for hematoma and hemorrhage in four stages at diff erent times. Results: There was no signifi cant diff erence in the terms of demographic features, catheter lumen size (P = 0.43), and number of attempting for CVC placement (odds ratio [OR] =2.35, 95% confi dence interval [CI] = 0.36–15.3, P = 0.39) between two groups. Seven out of 59 patients suff ered from complications (11.9%) that the complications in coagulopathic patients were oozing (5.7%) and superficial hematoma (8.6%) while in noncoagulopathic patients were 4.2% for both complications (OR = 0.54, 95% CI = 0.09–3.07, P = 0.767). Conclusion: According to our results, it can be concluded
that inserting CVC with ultrasound guidance under emergency conditions causes no serious and life-threatening complications in coagulopathic patients.

Key words: Central venous catheter, coagulopathy, emergency, shock, ultrasound