Left internal versus right internal jugular vein access to central venous circulation using the seldinger technique

Central venous catheterization is a standard procedure used in the resuscitation of critically ill patients. There are different routes of CVP insertion which are:- subclavian vein, internal jugular vein, axillary vein and femoral vein. Each route has its own set of complications like artery puncture, pneumothorax, nerve injury, infections. Initially catheters were inserted by the landmark technique using guidewire through the needle commonly called seldinger technique. The landmark technique is found to be associated with a higher range of mechanical complications. The use of USG however has proved to improve the success rate and decrease the complications. Keywords: Central venous catheterization, resuscitation, internal jugular vein.

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Insertion of a 1.9F central venous catheter via the internal jugular vein in neonates

Journal of International Medical Research ◽

10.1177/0300060520925380 ◽

2020 ◽

Vol 48 (6) ◽

pp. 030006052092538

Author(s):

Feixiang Luo ◽

Xiaoying Cheng ◽

Xiaofang Lou ◽

Qin Wang ◽

Xiaoyan Fan ◽

...

Keyword(s):

Central Venous Catheter ◽

Success Rate ◽

Internal Jugular Vein ◽

Neonatal Intensive Care ◽

Jugular Vein ◽

Venous Catheter ◽

Seldinger Technique ◽

Central Venous ◽

Minimal Trauma ◽

The Right

Objective This study aimed to develop a technique for placing a 1.9 French (F) central venous catheter in the internal jugular vein of newborns. Methods In this retrospective study, punctures were performed with a modified ultrasound-guided Seldinger technique with 57 1.9F catheters in 48 newborns. Punctures were performed in the right internal jugular vein in 43 (75.4%) patients and in the left internal jugular vein in 14 (24.6%) patients. Results We included 33 (57.9%) boys and 24 (42.1%) girls, aged a median 38 days (range, 2–135 days). The puncture success rate was 100%. Catheterization duration was a median 14 days (range, 1–70 days). Among the catheters, 94.1% were removed after completion of therapy or upon death. Fifty-three (93%) patients experienced no complication, whereas a small amount of bleeding was observed in 2 (3.5%) patients, inflammation of puncture in 1 (1.8%) patient, and occlusion in 1 (1.8%) patient. The method of placement of 1.9F catheters in the internal jugular vein of newborns had a high success rate, with minimal trauma and few complications. Conclusions Our method of placing a 1.9F central venous catheter in the internal jugular vein is suggested for level III to VI neonatal intensive care units.

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How much guidewire is too much? Direct measurement of the distance from subclavian and internal jugular vein access sites to the superior vena cava-atrial junction during central venous catheter placement

Critical Care Medicine ◽

10.1097/00003246-200001000-00023 ◽

2000 ◽

Vol 28 (1) ◽

pp. 138-142 ◽

Cited By ~ 74

Author(s):

Robert T. Andrews ◽

Dawn A. Bova ◽

Anthony C. Venbrux

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Direct Measurement ◽

Jugular Vein ◽

Superior Vena ◽

Vena Cava ◽

Venous Catheter ◽

Central Venous ◽

Central Venous Catheter Placement ◽

Vein Access

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Modified Seldinger technique for internal jugular open central venous line insertion in neonates: merging two different manoeuvers

Egyptian Pediatric Association Gazette ◽

10.1186/s43054-021-00078-8 ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Mohamed Mahmoud Shalaby ◽

Rami Mohammed Salama ◽

Mohammed Awad Mansour

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Guide Wire ◽

Venous Catheter ◽

Central Venous Line ◽

Seldinger Technique ◽

Central Venous ◽

Jugular Vein Thrombosis ◽

Line Insertion

Abstract Background Central venous line insertion in neonates is an important and lifesaving procedure. It can carry significant risks and complications, including death, at the time of insertion or later. We aimed to retrospectively assess the modified Seldinger technique for open placement of a central venous catheter in neonates, regarding its safety, feasibility, operative time, and preservation of the patency of the internal jugular vein. This study was conducted on 120 neonates from March 2018 to March 2020. We closely monitored the pulse for the detection of arrhythmia or bradycardia, which might be caused during the insertion of the guide wire or the tip of the catheter. Post-operative X-ray was done immediately after the end of the procedure for all cases, to determine the site of the central venous catheter and to detect the presence of pneumothorax. Results Arrhythmia was observed in 9 cases (7.5%), and blood oozing in 5 cases (4.1%). There were 3 cases of pneumothorax (2.5%), 2 cases of neck hematoma in two cases (1.6%), 6 cases of internal jugular vein thrombosis (5%), and dislodging of the catheter in 3 cases (2.5%). There were no cases of arterial puncture, failure of cannulation, or haemothorax in our study. Conclusions The modified Seldinger technique insertion for open central venous line in neonates is a safe, accessible, and feasible method, especially in centers that lack the experience of ultrasound-guided insertion in neonates.

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