Puncture point-traction method: A novel method applied for right internal jugular vein catheterization

Abstract

Abstract. The ultrasound probe and advancement of the needle during real-time ultrasound-assisted guidance of catheterization of the right internal jugular vein (RIJV) tend to collapse the vein, which reduces the success rate of the procedure. We have developed a novel puncture point-traction method (PPTM) to facilitate RIJV cannulation. The present study examined whether this method facilitated the performance of RIJV catheterization in anesthetized patients. In this study, 120 patients were randomly assigned to a group in which PPTM was performed (PPTM group, n=60) or a group in which it was not performed (non-PPTM group, n=60). One patient was excluded because of internal carotid artery puncture and 119 patients remained for analysis. The cross-sectional area (CSA), anteroposterior diameter (AD) and transverse diameter (TD) of the RIJV at the cricoid cartilage level following the induction of anesthesia and during catheterization were measured, and the number with obvious loss of resistance (NOLR), the number with easy aspiration of blood into syringe (NEABS) during advancement of the needle, and the number of first-pass punctures (NFPP) during catheterization were determined. In the non-PPTM group, the CSA was smaller during catheterization compared with that following the induction of anesthesia (P<0.01). In the PPTM group compared with the non-PPTM group during catheterization, the CSA was larger (P<0.01) and the AD (P<0.01) and TD (P<0.05) were wider; NOLR (P<0.01), NEABS (P<0.01) and NFPP (P<0.01) increased significantly. The findings from this study confirmed that the PPTM facilitated catheterization of the RIJV and improved the success rate of RIJV catheterization in anesthetized patients in the supine position.

Comparison of conventional needle holding technique and pen holding method of needle holding for real-time ultrasound-guided internal jugular venous cannulation – A randomised parallel-group study

“…described a novel puncture point-traction technique in which the skin just above the IJV is maintained in its position by the traction of surgical suture and found high success rate. [ 16 ] Gupta et al . described the novel technique of the pen holding method.…”

Proximal penholding method – A variant to enhance safety of ultrasoundguided central venous cannulation: A prospective pilot study

“…[12] Wu and Zang describe a novel puncture point-traction method that has been developed to facilitate right IJV cannulation, in which it is attempted to retain the puncture point of the skin directly above the right IJV in its original position by the traction of surgical suture. [13]…”