title: [Ultrasound-guided central venous access in patients with uncorrected coagulopathy].
abstract: BACKGROUND
  Correction of coagulopathy prior to central venous catheterization is a standard practice. Before ultrasound-guided procedures, routine correction of coagulopathy is controversial as mechanical complications are rare.
  
  
  OBJECTIVE
  To evaluate the safety of ultrasound-guided central venous access in critically ill patients with coagulopathy.
  
  
  METHODS
  In this retrospective study the authors included all ultrasound-guided central venous catheterizations performed in their Intensive Care Unit between February 2011 and January 2013. They defined coagulopathy as INR or APTT ratio above 1.5, platelet count below 100 G/l, and anticoagulation or clopidogrel therapy. Data obtained from ultrasound register and patient records were used.
  
  
  RESULTS
  310 ultrasound-guided central venous catheterizations were performed. Coagulopathy was observed in 134 cases (43.2%) and corrected in 10 cases prior to catheterization. There were no bleeding complications (complication rate in uncorrected coagulopathy: 0%, 95% confidence interval: 0-3.0%).
  
  
  CONCLUSIONS
  Coagulopathy is common in critically ill patients, but its routine correction prior to ultrasound-guided central venous catheterization seems unnecessary.
authors.affiliation: Központi Aneszteziológiai és Intenzív Betegellátó Osztály, Markhot Ferenc Kórház Eger, Széchenyi u. 27-29., 3300.
authors.forename: Géza
authors.initials: G
authors.lastname: Reusz
authors.forename: Csilla
authors.initials: C
authors.lastname: Langer
authors.forename: Tibor
authors.initials: T
authors.lastname: Hevessy
authors.forename: Ákos
authors.initials: Á
authors.lastname: Csomós
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001778:Blood Coagulation Disorders / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000379:methods / Q000592:standards / Q000639:trends; D000077144:Clopidogrel; D003422:Critical Care / Q000379:methods / Q000592:standards / Q000639:trends; D016638:Critical Illness; D005260:Female; D006801:Humans; D006814:Hungary; D019934:International Normalized Ratio; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D010976:Platelet Count; D012189:Retrospective Studies; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional; D019564:Unnecessary Procedures
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: alvadási zavar; central venous catheterization; centrálisvéna-biztosítás; coagulopathy; ultrahang; ultrasound