Batna Journal of Medical Sciences
Volume 13, Numéro 3, Pages 275-282
2026-05-29

Cathétérisme Veineux Central échoguidé En Réanimation : Expérience Du Centre Hospitalier D’essos (yaoundé, Cameroun)



Auteurs : Nga Nomo Serge Vivier . Kuitchet Njeunji Aristide Gilles . Iroume Bifouna Cristella Raissa .

Résumé

ABSTRACT Introduction: Central venous catheterization is a cornerstone of modern critical care, providing reliable vascular access for vasoactive drug administration, fluid resuscitation, and hemodynamic monitoring. However, landmark-based insertion techniques remain associated with a non-negligible risk of mechanical complications, particularly in resource-limited settings where anatomical variability, operator dependence, and clinical instability may increase procedural difficulty. Real-time ultrasound guidance has emerged as a key innovation to improve both safety and efficiency. This study aimed to evaluate the feasibility, procedural performance, and safety of ultrasound-guided central venous catheter (CVC) insertion in a tertiary intensive care unit in Cameroon. Methods: We conducted a 6-month prospective observational study in the intensive care unit of the Essos Hospital Center. Consecutive adult patients requiring CVC placement for therapeutic administration, vasopressor support, hemodynamic monitoring, or difficult peripheral venous access were included. All procedures were performed under real-time ultrasound guidance by trained anesthesiologist-intensivists using a standardized protocol. Data collected included patient demographics, indications, insertion site, number of attempts, procedural time, success rates, and immediate or early complications. Results: A total of 124 patients were enrolled (mean age 49.6 ± 17.3 years; 58.1% male). The main indications were prolonged intravenous therapy (41.9%), vasopressor administration (29.8%), difficult peripheral venous access (18.5%), and hemodynamic monitoring (9.8%). The right internal jugular vein was the most frequently used access site (61.3%). Overall success rate was 96.8%, with a first-attempt success rate of 84.7% and a mean number of attempts of 1.3 ± 0.6. Median procedural time was 12 minutes (IQR 8–18), and median time to functional infusion was also 12 minutes (IQR 8–18). Mechanical complications were rare (2.4%) and consisted exclusively of minor events, including arterial puncture (1.6%) and small hematoma (2.4%). No pneumothorax, major complication, or procedure-related mortality was observed. Conclusion: Ultrasound-guided CVC insertion is feasible, efficient, and highly safe in a resource-limited intensive care setting, with excellent success rates, rapid execution, and minimal complications, supporting its broader adoption in critical care practice.

Mots clés

Central venous catheterization ; Ultrasound guidance ; Intensive care unit ; Resource-limited settings

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