A new device for ultrasound-guided peripheral venous access

Background: In patients with difficult peripheral venous access, alternative techniques require expertise and are invasive, expensive, and prone to serious adverse events. This brought us to designing a new venous catheter (JLB® Deltamed, Inc.) for the cannulation of medium and large bore veins; it is echogenic, and available in different lengths (60 / 70 / 80 mm) and Gauges (14 / 16 / 17 / 18). Methods: We led a multi-center observational convenience sampling study to evaluate safety and effectiveness of JLB. Data was collected from June 2015 to February 2018. Inclusion criteria were age ⩾ 18, difficulty in obtaining superficial venous access in the veins of the arm, need for rapid infusion, or patient’s preference. Results: We enrolled 1000 patients, mean age 66.8 years. In total, 951 (95.1%) had the device placed in internal jugular vein, 28 in basilic or cephalic vein, 15 in femoral vein, 5 in axillary vein (infra-clavicular tract), and 1 in the external jugular vein. The procedure was performed by attending physicians or emergency medicine residents under US guidance. Mean procedure time (from disinfection to securing) was approximately 240 s. Mean attempts number was 1.21. Early complications (<24 h) occurred in four patients, consisting in two soft tissue hematoma, one phlebitis, and one atrial tachyarrhythmia. No major complications (such as pneumothorax) were reported. Mean indwelling time was 168 h (7 days); early occlusion/dislocation occurred in four cases. Conclusion: According to preliminary data, the application of JLB appears to be safe, cost-effective, and rapid to place bedside.

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Ultrasound-Guided Peripheral Venous Access vs. the External Jugular Vein as the Initial Approach to the Patient with Difficult Vascular Access

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2009.02.004 ◽

2010 ◽

Vol 39 (4) ◽

pp. 462-467 ◽

Cited By ~ 38

Author(s):

Thomas G. Costantino ◽

Jeremy F. Kirtz ◽

Wayne A. Satz

Keyword(s):

Vascular Access ◽

Jugular Vein ◽

Venous Access ◽

External Jugular Vein ◽

Ultrasound Guided ◽

Initial Approach ◽

Peripheral Venous Access

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Variation in the Course and Termination of the Cephalic Vein in the Deltopectoral Triangle

Acta Facultatis Medicae Naissensis ◽

10.1515/afmnai-2017-0011 ◽

2017 ◽

Vol 34 (2) ◽

pp. 99-106 ◽

Cited By ~ 2

Author(s):

Atoni Atoni Dogood ◽

Oyinbo Charles Aidemise

Keyword(s):

Subclavian Vein ◽

Jugular Vein ◽

Deltoid Muscle ◽

Venous Access ◽

External Jugular Vein ◽

Cephalic Vein ◽

The Other ◽

Axillary Vein ◽

Bilateral Presentation ◽

Surgical Emergencies

Summary The knowledge of cephalic vein variation would aid proper identification and prevent error in surgical emergencies. The path, distribution, and termination of the cephalic vein in relation to the deltopectoral triangle were studied in twenty formalin-embalmed cadavers. Results show the bilateral presentation of the cephalic vein in all the shoulders examined. Thirty-seven (37) cases presented with a superficial and lateral course of the cephalic vein in the deltopectoral groove, while the rest three cases presented a deep course. Of these 37 cases with the superficial course, two cases ascended anteriorly and above the clavicle and drained into the external jugular vein in the neck. Another case presented a cephalic vein that ascended anteriorly and then above the clavicle and drained into an unnamed vein in the neck. In one case, the cephalic vein ascended superficially in the deltopectoral groove and laterally in the deltopectoral triangle. In one bilateral pattern, the cephalic vein in the deltopectoral triangle drained into the axillary vein. In all the three cases where the cephalic vein ascended deep within the deltopectoral groove, they terminated deep in the deltopectoral triangle. In one of these, the cephalic vein received a tributary that originated from a venous network beneath the deltoid muscle and then drained into athe xillary vein, deep in the deltopectoral triangle. In the other two cases, the cephalic vein gave a tributary to the axillary vein and continued deep and medially in the deltopectoral triangle, passed below the clavicle and drained into the subclavian vein. The knowledge of these variations of the cephalic vein is essential to clinicians and surgeons for venous access during emergencies and surgery.

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Central venous access via the external jugular vein in cardiovascular surgery

Acta Anaesthesiologica Scandinavica ◽

10.1111/j.1399-6576.1986.tb02455.x ◽

1986 ◽

Vol 30 (6) ◽

pp. 470-472 ◽

Cited By ~ 10

Author(s):

P. Berthelsen ◽

B. Hansen ◽

P. Howardy-Hansen ◽

J. Mølller

Keyword(s):

Cardiovascular Surgery ◽

Jugular Vein ◽

Central Venous Access ◽

Venous Access ◽

External Jugular Vein ◽

Central Venous

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Triple-lumen Central Venous Access via the External Jugular Vein

CHEST Journal ◽

10.1378/chest.98.4.1040 ◽

1990 ◽

Vol 98 (4) ◽

pp. 1040-1041 ◽

Cited By ~ 4

Author(s):

Wayne J. Manishen ◽

Linda Paradowski

Keyword(s):

Jugular Vein ◽

Central Venous Access ◽

Venous Access ◽

External Jugular Vein ◽

Central Venous

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Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

Journal of International Medical Research ◽

10.1177/0300060518813514 ◽

2018 ◽

Vol 47 (2) ◽

pp. 1005-1009

Author(s):

Taehee Pyeon ◽

Jeong-Yeon Hwang ◽

HyungYoun Gong ◽

Sang-Hyun Kwak ◽

Joungmin Kim

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Present Report ◽

Large Diameter ◽

Venous Catheter ◽

Venous Access ◽

Central Venous ◽

The Right ◽

Gain Access

Central venous catheters are used for various purposes in the operating room. Generally, the use of ultrasound to insert a central venous catheter is rapid and minimally complicated. An advanced venous access (AVA) catheter is used to gain access to the pulmonary artery and facilitate fluid resuscitation through the internal jugular vein. The present report describes a case in which ultrasound was used in a 43-year-old man to avoid complications during insertion of an AVA catheter with a relatively large diameter. The sheath of the catheter was so thin that a dilator was essential to prevent it from folding upon insertion. Despite the use of ultrasound guidance, the AVA catheter sheath became folded within the patient’s internal jugular vein. Mechanical complications of central venous catheter insertion are well known, but folding of a large-bore catheter in the internal jugular vein has rarely been reported.

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A technique of chronic intravascular catheterization for monitoring haemodynamic and laboratory values in conscious swine

Laboratory Animals ◽

10.1258/002367797780600233 ◽

1997 ◽

Vol 31 (1) ◽

pp. 70-73

Author(s):

J. Haberstroh ◽

U. Mand ◽

I. Lücke ◽

H. Breuer ◽

M. Ahrens ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Medicine ◽

Surgical Intervention ◽

Jugular Vein ◽

Small Animal ◽

Venous Catheter ◽

External Jugular Vein ◽

Laboratory Values ◽

Catheter Tip ◽

Sheath Introducer

In human and small animal intensive care medicine percutaneous sheath introducer (PSI) sets are commonly used for repeated insertion of an arterial or a venous catheter with only one vascular puncture. We used PSI for chronic catheterization of swine with a Swan-Ganz thermodilution catheter via a surgically exposed external jugular vein. In this way we were able to change defective catheters or correct the position of the catheter tip without renewed surgical intervention.

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