Percutaneous cannulation of the internal jugular vein

English, I. C. W.; Frew, R. M.; Pigott, J. F. G.; Zaki, Mark

doi:10.1136/thx.24.4.496

Cited by 49 publications

(18 citation statements)

References 3 publications

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“…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%

“…The consequence is blind needleâ€oe¿ probing' which can precipitatecom plications and access failure rates of 7â€"19%, depending on the level ofexperience ofthe op erator [8,16,17,21,26]. Factors that signifi cantly contribute to probing with the needle and its consequences are unexpected thrombo sis of the right internal jugular vein and the in consistent anatomic relationship of the right internal jugular vein to the common carotid ar tery (Figs.…”

Section: Becausethe Internaljugular Vein Is Easilymentioning

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: Conclusion Sonographic Guidance Forcentral Veinaccess Viathmentioning

confidence: 99%

Section: Becausethe Internaljugular Vein Is Easilymentioning

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

View full text Add to dashboard Cite

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“…Subsequently, the same group reported a carotid puncture rate of \ 1% with the same technique. 7 Others, however, have reported a higher incidence of procedure failure and complications. A,13 Ultrasound-simulated IJV cannulation 969…”

Section: Discussionmentioning

confidence: 99%

“…The success rates for the central landmark approach in pregnant (63%) and non-pregnant women (73%) are lower than those reported in previous clinical studies describing this technique (range 80-100%). 7 This difference may be due to the methods that were used to assess the study end points. In our study, we considered that only one attempt was made when the image was generated by the transducer positioned over the mark on the subject's skin.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound simulation of internal jugular vein cannulation in pregnant and non-pregnant women

Siddiqui

Goldszmidt

Haque

et al. 2010

Can J Anesth/J Can Anesth

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Background Pregnancy alters the anatomic landmarks for internal jugular vein (IJV) cannulation. In this study, IJV cannulation was simulated, and success of the technique was evaluated using ultrasound. Methods Term pregnant women and non-pregnant female volunteers were recruited. The degree of difficulty in assessing neck anatomy was noted. The optimal insertion points for cannulation were marked on the skin of each subject according to the central landmark and palpatory techniques. The midpoint of a 15-10 MHz linear transducer was placed over each insertion point, and the vertical cursor of the ultrasound, which represented the path of the needle, was placed in the image. The outcome was an IJV puncture, a carotid artery (CA) puncture, or a missed attempt. Results One hundred and sixty-one women, 99 pregnant and 62 non-pregnant, were studied. The identification of landmarks was more difficult in pregnant women (P = 0.01). The rates of successful IJV punctures, CA punctures, and missed attempts did not differ significantly between pregnant and non-pregnant women. Carotid artery punctures using the central landmark technique in pregnant and non-pregnant subjects were 19% and 10%, respectively. Corresponding figures for the palpatory approach were 6% and 3%, respectively. The degree of IJV overlap of the CA in the palpatory technique was greater in pregnant women (38% vs 18% showed [ 75% overlap; P \ 0.001), a difference that remained after controlling for body mass index Conclusion The IJV overlies the CA to a greater extent in pregnant patients than in non-pregnant patients. Thus, a landmark approach for IJV cannulation might expose pregnant women to a greater risk of carotid puncture. This trial was registered at www.clinicaltrials.gov (NCT T00464828).

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