Central venous cannulation: ultrasound techniques

Flood, Simon; Bodenham, Andrew

doi:10.1016/j.mpaic.2012.11.004

Cited by 3 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Approaches developed by the Italian Group for Venous Access Devices (GAVeCeLT) that include the Rapid Assessment of the Central Veins (RaCeVA) and the Rapid Assessment of the Peripheral Veins (RaPeVA) are protocols that can be used to thoroughly evaluate vessels and surrounding structures (Pittiruti 2012). Thorough ultrasound assessment for vein selection reduces insertion-related complications (Flood and Bodenham 2013;Pirotte 2008). When urgency of placement is not necessary, time taken with selection of a location for cannula insertion in a stable area, away from joints and movement, results in lower rates of failure (Marsh et al 2017).…”

Section: Vessel Assessmentmentioning

confidence: 99%

Right Assessment and Vein Selection

Alexandrou

2019

Vessel Health and Preservation: The Right Approach for Vascular Access

View full text Add to dashboard Cite

Right assessment and selection of the best vein and location is the first stage of the vascular access cycle within quadrant 1 of VHP. This stage begins at the time of admission and continues as diagnosis is established and treatment initiated. Most patients receive their first intravenous device during the assessment in the emergency department, typically a PIVC is inserted in a hurried fashion, and location and method of insertion are often not optimal. Once the patient has stabilized, consideration can be given to the most appropriate vascular access device, one that will provide the administration of the prescribed therapy. Assessments of patient history, comorbidities, contraindications, available veins, diagnosis, and duration of therapy are factors that determine level of risk, the appropriate device, and most qualified inserter. Individuals with ultrasound training can apply their skills for assessment and selection of the right location and vein for device insertion.

show abstract

Section: Vessel Assessmentmentioning

confidence: 99%

Right Assessment and Vein Selection

Alexandrou

2019

Vessel Health and Preservation: The Right Approach for Vascular Access

View full text Add to dashboard Cite

show abstract

“…Nonparallel alignment of the ultrasound beam and the needle precludes constant observation of the needle tip on the screen [24]. In the longaxis technique, the visibility of the adjacent structures of the vein is very limited [25].…”

Section: Real-time Ultrasound Guidancementioning

confidence: 99%

Infraclavicular access to the axillary vein — new possibilities for the catheterization of the central veins in the intensive care unit

Gawda¹,

Czarnik²,

Łysenko

2016

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditio nally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. For this reason, the axillary vein seems to be a rational alternative approach. In this narrative review, we evaluate the usefulness of the infraclavicular access to the axillary vein. The existing evidence suggests that infraclavicular approach to the axillary vein is a reliable method of central vein catheterization, especially when performed with ultrasound guidance.

show abstract

“…Ultrasound (US)-guided catheterization has been recommended to increase the success rate while decreasing the time to cannulation and the complication rate of internal jugular vein (IJV) cannulation. 1 Despite the potential benefits of using US to guide IJV cannulation, it is often reserved for difficult situations when the traditional anatomical landmark-based technique is unsuccessful. However, strongly worded recommendations have prompted the increased availability of US equipment for this purpose, and its utility as a first choice ''go to'' method is gaining popularity.…”

mentioning

confidence: 99%

Novel maneuvers to increase the internal jugular vein diameter during ultrasound-guided cannulation

Kelsheimer

Maheshwari

2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Central venous catheterization is routinely performed during the perioperative period. Ultrasound (US)-guided catheterization has been recommended to increase the success rate while decreasing the time to cannulation and the complication rate of internal jugular vein (IJV) cannulation. 1 Despite the potential benefits of using US to guide IJV cannulation, it is often reserved for difficult situations when the traditional anatomical landmark-based technique is unsuccessful. However, strongly worded recommendations have prompted the increased availability of US equipment for this purpose, and its utility as a first choice ''go to'' method is gaining popularity. 2 Even with US, however, cannulation of the IJV can be challenging in patients with hypovolemia, an unstable cervical spine, a short thick neck, increased intracranial pressure, end-stage renal disease, previous IJV cannulations, and/or intraluminal obstruction. Techniques previously suggested to increase the diameter of the IJV, improve the cannulation success rate, and minimize complications include passive leg elevation, application of positive end-expiratory pressure, the Valsalva maneuver, and Trendelenburg positioning. 3 We suggest two novel occlusive techniques to increase the IJV diameter that may be helpful when conventional methods have failed.The spontaneously breathing patient is placed in the supine position with head turned away from the side of the cannulation. A pre-procedural US examination of the neck is then performed to locate the optimal site for IJV cannulation. Considerations include the location of the carotid artery and its distance from the IJV, IJV size, and luminal occlusion or obstruction. Additionally, the patency of the infraclavicular portion of the IJV and superior vena cava may be assessed by maneuvering the US probe toward the thoracic cavity at the superior end of the clavicle. 4 Once the optimal cannulation site is located, the US probe is then placed in a perpendicular position over the IJV ( Figure A) to obtain a short axis image ( Figure B).The first maneuver involves holding the US probe to obtain a short axis view of the IJV while an assistant applies gentle pressure to occlude the IJV at the superior end of the clavicle and inferior to the scanning plane ( Figure C). Pressure should be applied with just enough force to occlude the IJV lumen, which can be confirmed by sliding the US probe inferiorly. The increased IJV diameter-due to obstruction of the outflow of the IJV, leading to increased back pressure and subsequent IJV enlargement-is typically observed within a few seconds ( Figure D). A similar technique of distal obstruction to increase the radial artery size has been described. 5 The second maneuver involves occlusion of the contralateral IJV by an assistant applying gentle pressure ( Figure E). We hypothesize that the increase in diameter of the ipsilateral IJV ( Figure F) is due to obstruction of the outflow of the contralateral IJV, leading to back pressure and increased flow through the unobstructed IJV...

show abstract

Central venous cannulation: ultrasound techniques

Cited by 3 publications

References 5 publications

Right Assessment and Vein Selection

Right Assessment and Vein Selection

Infraclavicular access to the axillary vein — new possibilities for the catheterization of the central veins in the intensive care unit

Novel maneuvers to increase the internal jugular vein diameter during ultrasound-guided cannulation

Contact Info

Product

Resources

About