Ultrasound-Guided Cannulation of the Internal Jugular Vein. A Prospective, Randomized Study

Troianos, Christopher A.; Jobes, David R.; Ellison, Norig

doi:10.1213/00000539-199106000-00020

Cited by 279 publications

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“…In expert hands, the traditional technique is considered safe, but the reliability of anatomic landmarks is questionable because anatomic variations involving this vein and its relation to the internal carotid artery are encountered in a substantial number of cases [33,34]. When landmark-based insertion fails, success rates drop 25 % with each repeat attempt, and the number of attempts is closely correlated with the likelihood of complications [9], the most common of which is arterial puncture [6]. A number of studies [9][10][11][12][13] have shown that realtime ultrasound guidance increases the rates of successful internal jugular catheterization by 100 % (particularly on the first pass).…”

Section: Internal Jugular Veinmentioning

confidence: 99%

“…When landmark-based insertion fails, success rates drop 25 % with each repeat attempt, and the number of attempts is closely correlated with the likelihood of complications [9], the most common of which is arterial puncture [6]. A number of studies [9][10][11][12][13] have shown that realtime ultrasound guidance increases the rates of successful internal jugular catheterization by 100 % (particularly on the first pass). It also reduces the rates of mechanical complications (e.g., arterial puncture, hematoma, pneumothorax) as well as infectious and thrombotic events [15][16][17].…”

Section: Internal Jugular Veinmentioning

confidence: 99%

“…In 1986, Yonei et al [8] first described the use of real-time, two-dimensional ultrasound for cannulating the same vein. Since then, a number of studies [9][10][11][12][13][14] have demonstrated that real-time ultrasound guidance and, to a slightly lesser extent, ultrasound assistance markedly reduce the mechanical, infectious, and thrombotic complications of the central venous catheterization [15][16][17]. Compared with the conventional blind insertion, ultrasound assistance can also reduce the rates of catheterization failure and incorrect catheter placement, increase the likelihood of success at the first pass, shorten procedure times, and reduce costs.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications

et al. 2013

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Vascular access used in the treatment of patients involves central and peripheral vein accesses and arterial accesses. Catheterization of central veins is widely used in clinical practice; it is a necessary part of the treatment of patients in various settings. The most commonly involved vessels are the internal jugular, subclavian, and femoral veins. The mechanical, infectious, and thrombotic complications of central venous catheterization are markedly reduced when the procedure is performed with real-time ultrasound guidance or (to a slightly lesser extent) ultrasound assistance. Ultrasound guidance is also used to create peripheral venous accesses, for catheterization of peripheral veins and for peripheral insertion of central venous catheters. In this setting, it increases the catheterization success rate, especially during difficult procedures (e.g., obese patients, children) and reduces complications such as catheter-related infections and venous thrombosis. Arterial cannulation is used for invasive monitoring of arterial pressure and for access during diagnostic or therapeutic procedures. Ultrasound guidance reduces the risk of catheterization failure and complications. It is especially useful for arterial catheterization procedures performed in the absence of a palpable pulse (e.g., patient in shock, ECMO). Imaging support is being used increasingly to facilitate the creation of vascular accesses under difficult conditions, in part because of the growing use of ultrasonography as a bedside procedure. In clinical settings where patients are becoming increasingly vulnerable as a result of advanced age and/or complex disease, the possibility to reduce the risks associated with these invasive procedures should motivate clinicians to acquire the technical skills needed for routine use of sonographic support during vascular access procedures. Keywords Vascular access Á UltrasoundRiassunto Gli accessi vascolari utilizzati nella cura dei pazienti comprendono gli accessi venosi centrali e periferici e gli accessi arteriosi. L'incannulamento di accessi venosi centrali è manovra largamente diffusa nella pratica clinica e si rende necessaria per la cura dei pazienti in molteplici contesti. I vasi centrali che usualmente vengono incannulati sono la vena giugulare interna, la vena succlavia e la vena femorale. Nell'incannulamento venoso centrale sia l'eco-assistenza che l'eco-guida real time, pur con una leggera superiorità di quest'ultima, riducono drasticamente le complicanze meccaniche, infettive e trombotiche. La guida ecografica viene utilizzata anche per l'accesso venoso periferico, per l'incannulamento di vasi periferici e di vasi centrali a inserzione periferica (PICC). In questo contesto la guida ecografica aumenta il successo della manovra di incannulamento soprattutto in condizioni di difficoltà, come avviene nei pazienti obesi o nei bambini, e diminuisce le complicanze quali le infezioni catetere correlate e le trombosi venose. L'incannulamento arterioso viene utilizzato per il monitoraggio cruent...

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Section: Internal Jugular Veinmentioning

confidence: 99%

Section: Internal Jugular Veinmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications

et al. 2013

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“…The physician can visualize the vessels, check their patency, and carry out the puncture under direct vision. The result is a higher rate of success on the first attempt, lower rates of technical failure, fewer complications, and faster access [7,8]. Continuous improvement of cost-accessible portable scanners has placed US technology in the hands of specialists in numerous fields other than radiology.…”

Section: Introductionmentioning

confidence: 99%

Introducing ultrasound-guided vein catheterization into clinical practice: A step-by-step guide for organizing a hands-on training program with inexpensive handmade models

Domenico

Licausi

Porcile

et al. 2008

Journal of Ultrasound

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KEYWORDSCentral vein catheterization; Ultrasound; Handmade models; Training.Abstract Introduction: Central vein catheterization (CVC) plays a central role in hospital patient management. Compared with the use of traditional anatomical landmarks, ultrasound-guidance is associated with higher CVC success rates, fewer complications, and more rapid central venous access. The use of US-guided CVC in clinical practice has not become widespread, largely because anesthesiology and general surgery residents receive limited training in this technique. To increase the use of US-guided CVC in our surgical department, we organized a hands-on training program based on the use of handmade models. Methods: Three different models were constructed using plastic food-storage containers, segments of rubber tourniquet and silastic tubing (to simulate vessels), and agar gelatin. Results: The hands-on training course allowed progressive acquisition of the basic handeeye coordination skills necessary for performing US-guided venipuncture. The overall cost for each model was less than V5.00. Discussion: The models described in this report are useful tools for teaching US-guided CVC. Thanks to their low-cost, they can be widely used to facilitate the introduction of this technique in clinical practice.Sommario Introduzione: Il catetererismo venoso centrale (CVC) riveste un ruolo fondamentale nella gestione del paziente ospedalizzato. La tecnica eco-guidata è la metodica che assicura una più elevata percentuale di successo e permette un più sicuro e rapido posizionamento di CVC rispetto alla tecnica tradizionale. Tuttavia, la diffusione di tale metodica è ostacolata dall'assenza di uno specifico training durante i corsi di specializzazione in anestesia e chirurgia.Al fine di introdurre la tecnica eco-guidata, abbiamo organizzato un training producendo e utilizzando modelli in agar. Metodi: Sono stati costruiti tre differenti modelli utilizzando contenitori per alimenti, segmenti di laccio emostatico, tubo in silicone e gelatina a base di agar. Risultati: Un training specifico per la puntura eco-guidata è stato effettuato utilizzando i modelli prodotti. Il training ha consentito una rapida acquisizione delle basi tecniche per effettuare il posizionamento di CVC eco-guidato. Il costo medio di ogni modello è risultato inferiore a 5 euro. Discussione: I modelli prodotti in agar si sono rivelati un utile strumento per acquisire la coordinazione di base necessaria per la puntura eco-guidata. Il loro basso costo ne può permettere una ampia diffusione e può incentivare la realizzazione di nuovi percorsi educativi al fine di introdurre tale tecnica nella pratica clinica. ªa v a i l a b l e a t w w w . s c i e n c e d i r e c t . c

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“…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.…”

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confidence: 85%

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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Ultrasound-Guided Cannulation of the Internal Jugular Vein. A Prospective, Randomized Study

Cited by 279 publications

References 0 publications

Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications

Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications

Introducing ultrasound-guided vein catheterization into clinical practice: A step-by-step guide for organizing a hands-on training program with inexpensive handmade models

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

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