Comparison of Ultrasound-Guided and Landmark-Guided Central Venous Catheterization Success Rate and Complications

Abstract

Background: Central venous catheterization (CVC) is widely used in perioperative and critical care practice but may be associated with multiple attempts and mechanical complications. Ultrasound guidance may improve procedural success and safety compared with the conventional anatomical landmark technique. Objectives: The purpose of this study was to compare ultrasound-guided (USG) and landmark-guided (LMG) internal jugular CVC in terms of first-attempt success, overall success, number of attempts, procedural time, and mechanical complications. Materials and Methods: Patients were allocated equally to an USG group (n = 70) and a LMG group (n = 70). The primary outcome was first-attempt catheterization success. Secondary outcomes included overall success within three attempts, number of puncture attempts, access time, total catheterization time, and procedure-related mechanical complications. Statistical significance was set at P < 0.05. Results: First-attempt success was significantly higher in the USG group than in the LMG group (91.4% vs. 71.4%; P = 0.002). Overall success within three attempts was 98.6% and 91.4%, respectively. Patients in the USG group required fewer puncture attempts (1.11 ± 0.40 vs. 1.43 ± 0.73; P = 0.002). Conclusion: USG internal jugular CVC provides higher first-attempt success, requires fewer attempts, shortens procedural time, and reduces overall mechanical complications compared with the anatomical landmark technique.