Cerebral venous blood is not drained via the internal jugular vein in the pig

A 4-year-old child with chronic enteropathy underwent left percutaneous internal jugular vein Hickman catheter insertion for total parenteral nutrition (TPN) under general anaesthesia. Previously this child had undergone percutaneous Hickman line insertion on the right internal jugular vein in 2013 and the right subclavian vein in 2015. These lines had been removed before due to catheter sepsis. During the present procedure, 6.6 french Hickman line was inserted into the left internal jugular vein by percutaneous peel away technique under ultrasound guidance. Later in the ward it was noticed that Hickman line was not functioning and there was reverse flow of blood into the intravenous (IV) line. Blood gas sample taken from the line showed arterial values and the catheter was subsequently removed. Computed tomography (CT) angiography was done which reported arteriovenous (AV) fistula with pseudoaneurysm of the right subclavian vein. The child was then referred to department of cardiothoracic surgery for further management. From the above case report we can infer that patients who underwent repeated percutaneous central line insertions may develop iatrogenic AV fistula or pseudo aneurysm. These complications can be asymptomatic for years. Failure to recognize this may lead to catastrophe during reinsertion. Hence proper history taking, clinical examination for bruit, thrill over the neck veins and cardiac examination should be done preoperatively if there is past history of multiple insertions. Investigations like venous blood gas sampling, USG doppler for neck veins, echocardiography, and CT angiography should be done in these cases preoperatively.

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Difference between values of gas analysis of arteries and internal jugular vein in patients with cerebral infarction

Acta chirurgica iugoslavica ◽

10.2298/aci0802151d ◽

2008 ◽

Vol 55 (2) ◽

pp. 151-159

Author(s):

L.R. Danilovic ◽

B.D. Milakovic ◽

M.M. Dostanic ◽

M.M. Stoic ◽

B.V. Baljozovic ◽

...

Keyword(s):

Cerebral Infarction ◽

Internal Jugular Vein ◽

Right Hemisphere ◽

Jugular Vein ◽

Venous Blood ◽

Gas Analysis ◽

Results Of Treatment ◽

Significant Difference ◽

Left And Right

Introduction. Cerebral infarction is more and more frequently present by massive participation and high percentage of mortality even in young population. It is notified as very hard, vitally endangered disease. Objective. To prove whether there is a difference in the gas analyses of the arterial and cerebral venous blood between the patients with the cerebral infarction of the left and right hemisphere and why it is significant for the treatment of those patients. Material and methods. Sixty-five (65) patients of both sexes who were diagnosed by CT as: cerebral infarction, cerebral multiinfarctions and cerebral haemorrhagic infarctions were investigated. Under the same conditions their radial artery and left and right internal jugular vein were tapped - on the fourth, eighth and tenth day of their disease. Gas analysis, calculation of oxygen content and statistical comparison of testing results were performed from the samples of arterial and venous blood. Results. By continuous monitoring of gas analysis parameters of arterial and cerebral venous blood from internal jugular vein, we can follow up the phases of disease, the velocity of changes of gas analysis parameters and adequacy of brain circulation and to correct therapy adequately for the purpose of preventing basic disease complications and to estimate the results of treatment. Conclusion. There is a significant difference between the results of gas analysis of arteries and the internal jugular vein, in patients with infarctions of the left and right hemisphere of the brain.

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Dissolved Oxygen Changes the Color of Venous Blood as Arterial Blood during the Test Puncture of the Internal Jugular Vein

Anesthesiology ◽

10.1097/00000542-200209002-00233 ◽

2002 ◽

Vol 96 (Sup 2) ◽

pp. A233

Author(s):

Masato Hara ◽

Seiji Watanabe ◽

Atsuko Hara ◽

Tatsuhiko Kano

Keyword(s):

Dissolved Oxygen ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Venous Blood ◽

Arterial Blood

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Retrograde Catheterization of the Right Internal Jugular Vein for Serial Measurements of Cerebral Venous Oxygen Content

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.1989.101 ◽

1989 ◽

Vol 9 (5) ◽

pp. 717-720 ◽

Cited By ~ 78

Author(s):

Mogens Jakobsen ◽

Erna Enevoldsen

Keyword(s):

Carotid Artery ◽

Oxygen Content ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Venous Blood ◽

Blood Samples ◽

Venous Oxygen Content ◽

The Right ◽

Serial Measurements

Serial measurements of CBF and metabolism require multiple cerebral venous blood samples. Retrograde catheterization of the right internal jugular vein is easily performed at a point 2.5–3 cm lateral to, and 2 cm above, the medial end of the right clavicula. Complications are few and minor. In 1/80 (1.25%) cases the carotid artery was punctured during cannulation. Insertion of the catheter for 16–18 cm reduces contamination with extracerebral blood to a minimum.

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Levels of amino acids and homoarginine in the venous basins of the brain and the heart muscle in patients with ischemic heart disease

The Scientific Notes of the I P Pavlov St Petersburg State Medical University ◽

10.24884/1607-4181-2020-27-2-25-31 ◽

2020 ◽

Vol 27 (2) ◽

pp. 25-31

Author(s):

N. S. Molchan ◽

T. Yu. Reypol'skaya ◽

T. F. Subbotina ◽

A. A. Zhloba ◽

Yu. S. Polushin

Keyword(s):

Heart Failure ◽

Amino Acids ◽

Heart Disease ◽

Energy Metabolism ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Venous Blood ◽

Reversed Phase ◽

Functional Class ◽

Class Iii

Introduction. Under the conditions of circulatory disorders and coronary heart disease (CHD), amino acids acquire additional value as a source of intermediates of Krebs cycle, participating in cell energetics. If there is a disturbance of energy metabolism, the level of amino acids in the blood can change, including the minor non-encoding amino acid homoarginine (hArg).The objective of this study was to compare the shifts in the levels of hArg and other amino acids in the venous blood flowing from the tissues of the heart and brain versus their levels in blood plasma from the cubital vein in patients with CHD.Methods and materials. The study used plasma samples of 58 patients (46 men and 12 women) aged 62 (57 — 66) years with CHD and heart failure of functional class III (NYHA). The level of hArg and the spectrum of 22 other amino acids were determined by the reversed-phase high-performance liquid chromatography (HPLC). Besides, the levels of lactic acid (LA) were determined by spectrophotometric method, as well as routine biochemical parameters were determined using standard kits.Results. Patients with CHD had compensated, without significant deviations, biochemical data of glucose level, lipid and nitrogen metabolism profiles. The level of hArg in the patient group of 1.4 (1.0—1.9) p.M was significantly lower compared to the reference interval, and the level of total homocysteine was increased, although there were no differences depending on the venous basin. The highest concentrations of LA, alanine and glutamine were detected in the plasma from the internal jugular vein. At the same time, lower concentrations of arginine, lysine and alanine corresponded to the lowest values of hArg.Conclusion. In patients with CHD and heart failure, a significant increase in the levels of glutamine and alanine in plasma from the internal jugular vein and coronary sinus in comparison with plasma from the cubital vein was accompanied by profound dysregulation of energy metabolism with the decrease in hArg levels.

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