Duplex Ultrasonography Performed by Nurses
Duplex Ultrasonography Performed by Nurses
Catheter-related thrombosis (CRT) has been found as the major complication of the established
 central venous catheter in intensive care unit (ICU) patients. Its reported incidence varies
 from 5 to 66 %. Although most cases are asymptomatic, in up to 10 - 15 % of the patients
 pulmonary embolism occurs. In addition, CRT is associated with the risk of infection,
 post-thrombotic syndrome and with general disruption of the management of the underlying
 disease. The most accessible diagnostic method for CRT recognition is duplex ultrasonography.
 However, screening of CRT by duplex ultrasonography is not common approach in ICUs. Normally,
 duplex ultrasonography is performed by physicians. In this setting, implementation of the
 screening in ICU would be time consuming and practically unrealizable. Delegating this
 competence to ICU nurses can increase availability of this screening method.

 Therefore, as a first step, investigators decided to perform a validation clinical study to
 verify the diagnostic accuracy of duplex ultrasonography of the venous system for CRT
 screening performed by a general nurse.
Approximately 150 patients with central venous catheter will be enrolled in this study.

 Investigators:

 1. General nurses - trained and able to perform duplex ultrasonography examination of
 venous circulation

 2. Doctors - experienced specialists in intensive care or urgent medicine

 Every patient with central venous catheter enrolled in clinical study is examined with duplex
 ultrasonography within 24 hours by both investigators, doctor and nurse. Each examination
 includes ultrasonography of a whole vena cava venous system with central venous catheter,
 bilaterally. Results of both examinations are blinded until the end of study, with one
 exception. In case of positive result - catheter related thrombosis is present, investigator
 ( nurse )informs patients attending physician.

 Results of investigations are recorded in Investigation Form with some other routine medical
 data.

 Timetable:

 18.3.2019 - 30.6.2020: Enrolling, collection of data 1.7.2020 - 30.9.2020: Finalization od
 database, statistic analysis 1.10.2020 - 31.1.2021: Preparation of publications 1.2. 2021 -
 31.12.2021: Result presentation
Inclusion Criteria:

 -  central venous catheter more than 48 hours in situ

 -  consent of a patient

 Exclusion Criteria:

 -  technical difficulties of ultrasound machine

 -  unfavorable local findings - inflammation of skin, excoriation etc.