Effects of clinical maneuvers on sonographically determined internal jugular vein size during venous cannulation

Mallory, Douglas L.; Shawker, Thomas H.; Evans, Robert G.; McGee, William T.; Brenner, Matthew; Parker, Margaret M.; Morrison, Gary; Mohler, Pamela A.; Veremakis, Christopher; Parrillo, Joseph E.

doi:10.1097/00003246-199011000-00017

Cited by 78 publications

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“…[15][16][17][18][19][20] This study took various anthropometric measurements, anatomical considerations & biochemical parameters into considerations. As suggested by Thomas Surez et al 21 the knowledge of anatomy of neck is vital and the relationship of the IJV to the sternocleidomastoid muscle and CA is the key for understanding the position of the vein in the neck. In practice, surface markings are always not reliable means of locating the Internal Jugular Vein as its position, particularly in a lateral plane tends to vary considerably.…”

Section: Discussionmentioning

confidence: 99%

A study on complications in land mark technique catheterization of internal jugular vein

Havaldar

Shaik

2015

Int J Res Med Sci

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INTRODUCTIONThe traditional methods of using anatomic landmarks to guide cannulation of the IJV have yielded various rates of successful access and complications. Moreover, central venous catheterization requires considerable expertise. Paul F. Mansfield et al. 1 showed that femoral catheterization had more mechanical complications of arterial puncture and hematoma, and catheter related infections were high and were grossly contaminated in inguinal region. The mechanical complication in subclavian vein catheterisation was severe pneumothorax and was less likely to be tolerated in severe hypoxemic patients necessitating avoidance in them. Pat O. Daily et al. 2 showed that internal jugular vein could easily be identified by anatomical position in the neck, usually positioned in intimate contact, and laterally and anteriorly to the carotid artery. Hence, the essential anatomical landmarks are the sternal and clavicular attachments of sternocleidomastoid muscle and the clavicle forming a triangle with internal jugular vein located in the groove between the two portions of sternocleidomastoid muscle. The specific anatomical relationship between the internal jugular vein and carotid artery has previously been well elucidated by Troinos et al. 3 and others. P J Alderson et al. 4 study revealed that internal jugular vein catheterisation is difficult in morbidly obese patients, in whom the landmarks of the neck are obscured. Also, the insertion of central venous lines is not without hazard and carries the potential for serious complications. The ABSTRACT Background: The traditional methods of using anatomic landmarks to guide cannulation of the IJV have yielded various rates of successful access and complications. Moreover, central venous catheterization requires considerable expertise. Cannulation of the IJV was first described in 1969. Various positions were used to access cannulation but they were frequently associated with complications such as arterial puncture, pneumothorax, neurological damage, infection, dysrhythmias, atrial thrombus, cardiac rupture. Methods: Thirty critical care patients were selected for IJV cannulation either by Land mark technique. This study conducted in department of anaesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. India. Results: In our study there was 83.3% success in LMG technique. The mean access time was 323.23 ± 146.19 sec and the distribution of complications encountered during the study, Carotid artery was accidentally punctured in 1 (3.3%) cases. In LMG technique, there were no cases of arrhythmias, haematoma, pneumothorax, haemothorax, nerve injury and catheter malposition were noted during the study. Conclusion: Land mark technique catheterization of internal jugular vein was shown complications than newly developed ultrasound guided method.

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Section: Discussionmentioning

confidence: 99%

A study on complications in land mark technique catheterization of internal jugular vein

Havaldar

Shaik

2015

Int J Res Med Sci

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“…On the other hand, high frequencies provide image clarity for only a limited depth ( Figure 2). 19 In general, high-frequency probes are used, as the internal jugular vein is relatively superficial.…”

Section: Frequencymentioning

confidence: 99%

“…The Trendelenburg position also increases the surface area of the jugular vein by 37% on average, and the maximum diameter can be reached at a 15°angle. 19 If the trachea is not intubated, the Valsalva maneuver will tend to increase the cross-sectional area of the internal jugular vein by 25%. 19 At this point, it is important to recognize thrombosis or atrophy of the internal jugular vein, both of which are absolute contraindications to jugular vein catheterization.…”

Section: Identifying the Veinmentioning

confidence: 99%

“…Par contre, la clarté de l'image obtenue par une haute fréquence se fait au détriment d'une visualisation superficielle (Figure 2). 19 Habituellement, on utilise des sondes à haute fréquence parce que la veine jugulaire interne est relativement superficielle.…”

Section: Sélection De La Sonde Et De La Modalitéunclassified

“…La position de Trendelenburg augmente l'aire de la veine jugulaire de 37 % en moyenne et le diamètre maximal peut être atteint avec un angle de 15°. 19 Chez un patient non intubé, la manoeuvre de Valsalva aura tendance à augmenter l'aire de la veine jugulaire interne de 25 %. 19 C'est à cette étape qu'il est important de reconnaître la thrombose ou l'atrophie de la veine jugulaire interne, étant des contre-indications absolues à la canulation jugulaire.…”

Section: Identification De La Veineunclassified

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Ultrasound guidance for internal jugular vein cannulation: Continuing Professional Development

Ayoub

Lavallée

Denault

2010

Can J Anesth/J Can Anesth

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Purpose The objective of this continuing professional development module is to describe the role of ultrasound for central venous catheterization and to specify its benefits and limitations. Although ultrasound techniques are useful for all central venous access sites, the focus of this module is on the internal jugular vein approach. Principal findings In recent years, several studies were published on the benefits of ultrasound use for central venous catheterization. This technique has evolved rapidly due to improvements in the equipment and technology available. Ultrasound helps to detect the anatomical variants of the internal jugular vein. The typical anterolateral position of the internal jugular vein with respect to the carotid is found in only 9-92% of cases. Ultrasound guidance reduces the rate of mechanical, infectious, and thrombotic complications by 57%, and it also reduces the failure rate by 86%. Cost-benefit analyses show that the cost of ultrasound equipment is compensated by the decrease in the expenses associated with the treatment of complications. In this article, we will review the history of ultrasound guidance as well as the reasons that account for its superiority over the classical anatomical landmark technique. We will describe the equipment needed for central venous catheterization as well as the various methods to visualize with ultrasound. Conclusion To improve patient safety, we recommend the use of ultrasound for central venous catheterization using the internal jugular approach. ObjectivesAfter reading this module, the reader will be able to:1. Understand the rationale behind the use of ultrasound for central venous catheterization; 2. Identify anatomical variations in vascular structures in the neck; 3. Recognize the benefits and limitations related to the use of ultrasound; and 4. Adopt an ultrasound-guided approach in everyday practice.Over the years, anesthesiologists have adopted new technologies that are used for clinical monitoring and intraoperative diagnosis as well as for performing various techniques. These advances assist the anesthesiologist in performing procedures that may be associated with significant complications. One such procedure is central venous catheterization, which can be simplified and made safer with ultrasound. The main objective of this article is to explain the scientific and clinical foundations supporting the role of ultrasound in central venous catheterization. We will focus exclusively on the internal jugular vein approach. 123 Can J Anesth/J Can Anesth (2010) 57:500-514 DOI 10.1007/s12630-010-9291-7 Historical perspectiveThe main indications for central venous catheterization in the operating room or intensive care unit (ICU) include central venous pressure monitoring, the insertion of a pulmonary artery catheter, and the administration of drugs, such as antibiotics, vasopressors, inotropes, and chemotherapeutic agents. These catheters are also used to administer parenteral nutritional support, and they are needed for procedures such as...

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A special anatomic preparation for teaching central venous catheterization

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Effects of clinical maneuvers on sonographically determined internal jugular vein size during venous cannulation

Cited by 78 publications

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A study on complications in land mark technique catheterization of internal jugular vein

A study on complications in land mark technique catheterization of internal jugular vein

Ultrasound guidance for internal jugular vein cannulation: Continuing Professional Development

A special anatomic preparation for teaching central venous catheterization

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