Outcome variables
hemothorax, CLA-BSI, infection, flashback, hematoma, venous thrombosis
PNEUMOTHORAX, HEMOTHORAX, COMPLICATIONS, INFECTION, HEMATOMA, VENOUS THROMBOSIS
The primary outcome was the first-puncture success rate, defined as the incidence of successful puncture in the target vein at first needle insertion attempt. In addition, we assessed other incidences including first-puncture single-pass catheterization success rate, defined as the incidence of successful catheterization whereby the guidewire, dilator, and catheter were all successfully inserted without any withdrawal for redirection or reinsertion at the first needle puncture attempt and successful final catheterization; number of puncture attempts; puncture time; total catheterization time; complications including immediate mechanical complications such as undesired puncture (multiple skin breach with redirection of the needle), hematoma, posterior venous wall puncture, arterial puncture, pneumothorax, and hemothorax and late complications such as venous thrombosis and central line-associated blood stream infection (CLA-BSI) within 30 days after cannulation; and operator confidence score.Puncture time was defined as the period between skin penetration by the needle and the first flashback of blood. The total catheterization time was defined as the period between the probe positioning on the patient’s skin and insertion of the catheter. The operator confidence score was graded according to their degree of confidence during the CVC procedure: 1-point, lack of confidence in the first puncture success; 2-point, intermediate grade; 3-point, very confident in the first puncture success.