A New Method for Longitudinally Increasing the Internal Jugular Vein Diameter During Ultrasound-Guided Cannulation

Yoshida, Hitoshi; Yaguchi, Shinya; Kudo, Takashi; Ono, Tomoko; Hirota, Kazuyoshi

doi:10.1213/ane.0b013e318263c8e3

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…The margin of safety was defined as the distance from the lateral-most border of the IJV and the lateral-most border of the CA at which the IJV could be punctured without touching the CA; these distances were found to be similar between the different head positions in the present study (9,10, and 11 mm in the >30 left, neutral, and <30 right position, respectively; Table 3). However, Wank et al 13 defined the margin of safety as the absolute distance between the midpoint of the RIJV and the lateral-most border of the CA, and showed that the margin of safety significantly decreased when the head was turned to 90 .…”

Section: Discussionmentioning

confidence: 57%

“…The Trendelenburg position, Valsalva maneuver, humming, 6 positive end-expiratory pressure (PEEP), 7 skin-traction method, 8 and lifting the probe straight upward 9 combine the advantages of the short-and long-axis approaches while US-guided IJV cannulation 10,11 primarily focuses on dilating the IJV. Head rotations not only facilitate the visibility of anatomical landmarks for RIJV cannulation by clearing the chin, 12 but they also change the position of the RIJV with respect to the CA.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between the Right Internal Jugular Vein and Carotid Artery at Ipsilateral Head Rotation

et al. 2013

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Ultrasound-guided right internal jugular vein catheterization (RIJV) should be the first choice to decrease the catheterrelated complications in high-risk hemodialysis patients. For this procedure, clinicians should identify the optimum positions of the RIJV, including its lower overlap with the carotid artery (CA) and high cross-sectional area of the vein. The aim of this prospective randomized study to evaluate the effects of mild ipsilateral head rotation combined with Trendelenburg position on RIJV cross-sectional area and its relation to the CA in adult patients. Forty ASA I-II patients who were undergoing elective surgery were enrolled for this study. The subjects were asked to remain supine in the 15-20Trendelenburg position. Two-dimensional ultrasound was then used to measure the degree of overlap between the RIJV and CA, the cross-sectional area of the RIJV. These measurements were compared between head rotation to the >30 left, <30 left, neutral, and <30 right positions. When the head was in the >30 left position, overlap was seen in 38 of 40 patients (95%). As the head was rotated from >30 left to <30 right, the CA-RIJV overlap (from 95% to 57.5%), and the cross-sectional area (from 14.2 mm to 8.7 mm) significantly decreased. In conclusion, when the head was turned to <30 right, the CA-RIJV overlap significantly decreased, and the cross-sectional area also decreased. When clinicians determine the optimal head position before RIJV cannulation, it is important to consider the advantages and disadvantages of the different head positions from >30 left to <30 right.

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Relationship between the Right Internal Jugular Vein and Carotid Artery at Ipsilateral Head Rotation

et al. 2013

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Cannulation needle-induced anterior wall tenting of internal jugular vein causing posterior wall penetration

et al. 2014

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Unintentional posterior venous wall penetration during internal jugular vein (IJV) cannulation may cause critical arterial injuries in spite of ultrasound guidance. We aimed to evaluate whether small venous diameter and anterior venous wall tenting by a needle would be associated with posterior venous wall penetration, and to seek factors related to the venous wall tenting. We conducted a retrospective review in patients who underwent IJV cannulation. Using an ultrasound view obtained when puncturing, venous diameter, venous wall thickness, anterior venous wall tenting length, and needle angle were measured, and posterior venous wall penetration was determined. Eleven cannulations in 56 patients were assigned to posterior venous wall penetration. Small venous diameter (p = 0.004), and long anterior venous wall tenting (p = 0.007) were associated with posterior venous wall penetration. The longer anterior venous tenting would be expected with reducing needle angle (p = 0.004) or increasing anterior venous wall thickness (p = 0.006). In conclusion, small IJV and anterior venous wall tenting lead to posterior venous wall penetration. Anterior venous wall tenting is longer with reducing needle angle, or increasing the anterior venous wall thickness.

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A New Method for Longitudinally Increasing the Internal Jugular Vein Diameter During Ultrasound-Guided Cannulation

Cited by 2 publications

References 6 publications

Relationship between the Right Internal Jugular Vein and Carotid Artery at Ipsilateral Head Rotation

Relationship between the Right Internal Jugular Vein and Carotid Artery at Ipsilateral Head Rotation

Cannulation needle-induced anterior wall tenting of internal jugular vein causing posterior wall penetration

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