Needle tip visualization during ultrasound-guided vascular access: short-axis vs long-axis approach

Stone, Michael B.; Moon, Cynthia H.; Sutijono, Darrell; Blaivas, Michael

doi:10.1016/j.ajem.2008.11.022

Cited by 185 publications

(153 citation statements)

References 14 publications

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“…Most studies on short -axis view and its comparison to anatomical landmark-guided technique have not mentioned the duration of different catheterization steps. The access time was 17.72 seconds in Group 1 (SAG) in our study and 12.4 -240 seconds in other studies (1,(8)(9)(10)(11). Access time in Group 2 (M-OG) was shorter compared to Group 1, but the difference was not statistically significant.…”

Section: Discussionsupporting

confidence: 51%

Comparison of US-Guided Catheterization of the Right Internal Jugular Vein Using Medial-Oblique and Short Axis Techniques

Kamalipour¹,

Shahbazi²,

Derakhshan³

et al. 2015

Int Cardiovasc Res J

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A B S T R A C TBackground: Although some investigations have shown higher rates of successful first attempt and fewer attempts by using ultrasound-guided Internal Jugular Vein (IJV) catheterization, arterial puncture is still common. Objectives: The present study aimed to investigate US-guided catheterization of the right IJV via medial-oblique technique and also compare this technique to short-axis technique in open-heart surgery patients. Patients and Methods: In this randomized clinical trial, 80 patients referred to cardiac operating room of Namazi hospital, Shiraz, Iran from March to July 2014 were selected using census method. Block randomization with website was also done. Then, the patients were divided into two groups of 40, Short Axis Group (SAG) and Medial-Oblique Group (M-OG). For short-axis technique, patient's head was positioned at zero degree angulation with his trunk. For medial-oblique technique, on the other hand, patient's head was tilted to left to 45 degrees between the head and trunk. Sex, age, Body Mass Index (BMI), access time, guidewire time, cannulation time, total attempts for catheterization, first, second, and third attempt success, arterial puncture, hematoma, bleeding, and catheter malposition were recorded. The overlap between the carotid artery and IJV in zero-and 45-degree angulation was estimated through ultrasound print. After all, Kolmogorov-Smirnov test was used to assess normal distribution of the data. Then, the data were analyzed through Student's t-test, Mann-Whitney U test, and chi-square test. P < 0.05 was considered as statistically significant. Results:The results showed no significant differences between the two groups regarding the duration of different catheterization steps (P = 0.376). In all the cases in both groups, accessing the vein was successful with three attempts or less. There were no clinical complications of catheterization in the two groups. The mean of overlap was 23.60 ± 33.47 in zero-degree angulation between the head and trunk and 32.72 ± 36.38 in 45-degree angulation and this difference was statistically significant (P = 0.001). Conclusions:The results of the present study showed that both US-guided techniques under investigation had the same duration in different catheterization steps, total success rate, and primary mechanical complications, and could be used in clinics.

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Section: Discussionsupporting

confidence: 51%

Comparison of US-Guided Catheterization of the Right Internal Jugular Vein Using Medial-Oblique and Short Axis Techniques

Kamalipour¹,

Shahbazi²,

Derakhshan³

et al. 2015

Int Cardiovasc Res J

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“…The in-plane puncture technique may require more training, because it implies having the skills to direct the needle exactly within the plane of the probe. Although the evidence base is not yet strong in this regard [20,[45][46][47], this expert panel believes that adequate training for ultrasound-guided central venous access should include knowledge and practice of both techniques.…”

Section: Recommendationsmentioning

confidence: 99%

International evidence-based recommendations on ultrasound-guided vascular access

Lamperti¹,

et al. 2012

Self Cite

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“…It should also be noted that the procedure can be carried out during surgery because the abducted position of the upper extremities is common in the operating room, thus further reducing the time required. This is a clear advantage over the traditional external landmark technique where the adducted position of the upper extremity is required and forces the anesthesi-ologist to cannulate the IJV in the operating setting, associated with a higher incidence of infection and thrombosis [8] [9] [10].…”

Section: Discussionmentioning

confidence: 99%

“…The IJV is more popular due to the easier access and perceived lower risk of complications, however, subclavian vein (SCV) catheter placement is associated with a lower incidence of infection and thrombosis [8] [9] [10].…”

Section: Most Authors [1] [2] [3] [4]mentioning

confidence: 99%

Ultrasound-Guided Infraclavicular Axillary Vein Cannulation

García-Díaz¹,

Castro²

2017

IJCM

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Background and Objective: Percutaneous central venous cannulation is a common invasive procedure. In comparison with an external landmark technique, the advantages of ultrasound-guided venous access include direct visualization of the anatomy and in vivo visualization of venous cannulation. Methods: We evaluated an ultrasound-guided technique for infraclavicular axillary vein cannulation, focusing on its ease of use, success rate and complications rate. One hundred and twenty patients who submitted to central venous catheter placement were punctured using our technique. The patients were positioned so that their ipsilateral upper limb was abducted at 90˚ to the longitudinal axis, which makes it possible to visualize the infraclavicular vessels due to the elevation of the clavicle, thereby improving accessibility. Results: Cannulation was successful in all patients. The median time from the start of the first puncture (of the skin) until the aspiration of blood was 15 s (range 7 -135 s). Both infraclavicular axillary veins were cannulated, and the vein was punctured successfully at the first attempt in 95% of the patients, without complications during the procedure. Conclusion: We propose an ultrasound-guided infraclavicular approach of the axillary vein, with a high success rate and no complications in the present cohort.

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Needle tip visualization during ultrasound-guided vascular access: short-axis vs long-axis approach

Cited by 185 publications

References 14 publications

Comparison of US-Guided Catheterization of the Right Internal Jugular Vein Using Medial-Oblique and Short Axis Techniques

Comparison of US-Guided Catheterization of the Right Internal Jugular Vein Using Medial-Oblique and Short Axis Techniques

International evidence-based recommendations on ultrasound-guided vascular access

Ultrasound-Guided Infraclavicular Axillary Vein Cannulation

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