Open Access Case Report

Ultrasound-Guided Central Venous Access Insertion in Prone Decubitus Position in Severe Covid-19 Patients: Case Report

Héctor Oswaldo Hernández Trinidad1, Felipe de Jesús Montelongo2*, Araceli Suarez Suarez1, Diana Otegui Jiménez1, Lleny Bocanegra Flores1, Jose de Jesus Rincon Salas1, Blanca Estela Herrera Morales3, Jorge Eduardo Montesinos Calderón1, Jonathan Galindo Ayala1, Rodolfo Sosa Barragan1, Guillermo Vazquez Tobías1 and César Humberto Botello Ortiz4

1Attending physician in the Intensive Care Unit, Hospital General Las Américas ISEM, Mexico

2Chief of the Intensive Care Unit, Hospital General Las Américas ISEM, Mexico

3Health Education and Research Coordinator IMSS, Mexico

4Health Education and Research State Coordinator, ISEM, Mexico

Corresponding Author

Received Date:September 08, 2021;  Published Date:September 21, 2021

Abstract

Objective: To describe the placement of ultrasound-guided central venous access in the prone position in patients with severe acute respiratory distress syndrome due to COVID-19.

Design: Transverse and prospective, with reports of cases of hospitalized patients.

Setting: Adult intensive care unit, of a second level teaching hospital in Ecatepec, State of Mexico.

Participants: Hospitalized patients diagnosed with severe PNEUMONIA due to COVID-19, who required prone position and placement of central venous access, were included from March to September 2020.

Primary outcome measures: Placement of central venous access in prone position guided by ultrasound.

Result: Three patients were included, with predominance of the male sex, with a grade II obesity in 66%, grade III obesity in 33%, with an average of 6 days in the prone position, two required the change and placement of catheter due to obstruction and one case for requiring the installation of a hemodialysis catheter due to the initiation of continuous slow therapy to replace renal function. The number of operators was one to two and the most common site of vascular insertion was the left jugular. The number of punctures was 1.6 times, with a puncture time to insertion of the metal guidewire of 45 to 55 seconds. None had complications.

Conclusion: The placement of central venous accesses in the prone position with ultrasound support is a procedure that facilitates insertion and is apparently fast and safe. However, it is a procedure of which there is little description within the international medical literature.

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