An assessment of an alternative method of internal jugular vein catheterisation

Latto, I. P.; Hughes, J. A.; Falconer, Randall

doi:10.1111/j.1365-2044.1992.tb04199.x

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…More importantly, othercomplications suchas hematoma, cata strophic hemorrhage, nerve paralysis, pneu mothorax, pseudoaneurysm, cardiac arrest, and death have occurred when these or similar landmark methods have been used [20â€"251. Depending on the experience of the operator, these complications can occur at a rate of 5â€" 10% 1261.Frequently, the complications result from the inability to accurately discern ana tomic landmarks when they are obscured by fat, edema, tachycardia, or unfavorable physi cal characteristics (e.g., short thick neck) [7].…”

Section: Becausethe Internaljugular Vein Is Easilymentioning

confidence: 99%

“…With theincreased use of thesemutes,manyhaverecognized signifi cant complications with subclavian vein access and now prefer to use the right internal jugular vein [2â€ "5]. The traditional method of using ana tomic landmarksto guide cannulation of the right internal jugular vein has yielded various rates for successful access and complications [6][7][8][9]. These rates depend not only on the experi ence of the operator but also on the underlying patency and anatomy ofthe right internal jugular vein.…”

Section: Conclusion Sonographic Guidance Forcentral Veinaccess Viathmentioning

confidence: 99%

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Sonographic guidance when using the right internal jugular vein for central vein access.

Caridi¹,

Hawkins²,

Wiechmann³

et al. 1998

American Journal of Roentgenology

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OBJECTIVE. The intentof thisstudywasto substantiate theadvantages of theuseof sonographic guidancefor centralvenousaccessvia the right internaljugular vein. SUBJECTSAND METHODS. Eightysequential patients requiring central veinaccesswere examined with a hand-held sonography transducer to determine the size, patency, and locationof the right internaljugular vein beforepuncture. Accessto the right internaljugular vein was subsequently performed, under sterile conditions, using sonographic guidance. Periprocedural complications were prospectively recorded. Subsequently, we compared our findingswith publishedreportsof complicationswhen visible and palpableanatomicland marks were used for guidance during cannulation of the internal jugular vein. RESULTS.Amongthese 80patients, theanatomy of therightinternal jugularveinwastypical in only 57 (71%). In another 13 patients (16%), sonography showed a medial position of the right internal jugular vein, anterior to the common carotid artery. In three other patients (4%), the right internaljugular vein was positioned laterally by more than 1 cm. In the remain ing seven patients (9%), the vein was thrombosed. Its diameter, measured without use of the Valsalva maneuver, also varied, measuring 0.5-2.0 cm. Cannulation was achieved in all 73 pa tients with a patent right internaljugular vein. One puncture was required in 68 patients (93%);two puncturesin threeotherpatients(4%); andthreepuncturesin the remainingtwo patients (3%). In no case was the common carotid artery inadvertently punctured. Only one periproce duralcomplicationoccurred, andit wasunrelatedto the useof sonographic guidance. CONCLUSION. Sonographic guidance forcentral veinaccess viatherightinternal jugular vein is safer and more efficient than the traditional landmark approach. 2â€"5]. The traditional method of using ana tomic landmarksto guide cannulation of the right internal jugular vein has yielded various rates for successful access and complications [6][7][8][9]. These rates depend not only on the experi ence of the operator but also on the underlying patency and anatomy ofthe right internal jugular vein. We believe that the use of a hand-held transducer for real-time sonography before the procedure and for guidance during the procedure canimproveaccess to therightinternal jugular vein and limit complications. Subjects and MethodsDuring a 3-month interval, 80 consecutive patients in whom a right internaljugular vein approachwas beingused for centralveinaccesswereexaminedbe fore the procedure with hand-held real-time sono graphic transducers. Either a Sonolayer SSH-140A(ToshibaAmericaMedicalSystems,Carroilton,TX) ora Site-Rite II (Dymax, Pittsburgh, PA)wasused to determinethe size, patency,and locationof the right internal jugular vein before puncture. To simulate the landmark approach, the patient's head was rotated 30'to the leftand scanningwas performedat the apexof bothheadsofthe sternocleidomastoid muscle.Thirty seven males and 43 females 15â€"76 years old were examined. For those patients who proceeded t...

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Section: Becausethe Internaljugular Vein Is Easilymentioning

confidence: 99%

Section: Conclusion Sonographic Guidance Forcentral Veinaccess Viathmentioning

confidence: 99%

Sonographic guidance when using the right internal jugular vein for central vein access.

Caridi¹,

Hawkins²,

Wiechmann³

et al. 1998

American Journal of Roentgenology

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show abstract

“…These findings are at variance with our experience in Cardiff, as illustrated by our incidence of venous transfixion in 20 consecutive patients presenting for cardiac surgery. The patients were placed in a horizontal position and a previously described method [3] was used to cannulate the internal jugular vein. A 21G, 40‐mm ‘seeker’ needle was used initially and an 18G, 70‐mm needle was then used for insertion of a Seldinger wire and triple‐lumen catheter.…”

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Avoid internal jugular vein transfixion

Latto

1999

Anaesthesia

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“…The reality is that there are always cases where it is not easy to locate the vein and multiple attempts need to be made. Quantitative data on the number of attempts to enter the vein both with the seeker needle and the main needle are available [3]. These data were collected when working with carefully supervised trainees.…”

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confidence: 99%