scholarly journals Ultrasound-guided anatomical evaluation and percutaneous cannulation of the right internal jugular vein in infants <4000 g

2019 ◽  
Vol 21 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Filiz Uzumcugil ◽  
Aysun Ankay Yilbas ◽  
Basak Akca
Keyword(s):  
Carotid Artery ◽  
Real Time ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Anatomical Variation ◽  
Complication Rates ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Vein Access ◽  
The Right

Background: The commonly preferred right internal jugular vein was investigated in terms of its dimensions, the relationship between its dimensions and anthropometric measures, and the outcomes of its cannulation in infants. Data regarding its position with respect to the carotid artery indicated anatomical variation. Aim: The aim of this study was to share our observations pertaining to the anatomy and position of the right internal jugular vein with respect to carotid artery using ultrasound and our experience with ultrasound-guided right internal jugular vein access in neonates and small infants. Materials and methods: A total of 25 neonates and small infants (<4000 g) undergoing ultrasound-guided central venous cannulation via right internal jugular vein within a 6-month period were included. Ultrasound-guided anatomical evaluation of the vein was used to obtain the transverse and anteroposterior diameters, the depth from skin and the position with respect to the carotid artery. Real-time ultrasound-guided central cannulation success rates and complication rates were also obtained. The patients were divided into two groups with respect to their weight in order to compare both the position and the dimensions of right internal jugular vein and cannulation performance in infants weighing <2500 g and ⩾2500 g. Results: The position was lateral to the carotid artery in 84% of all infants and similar in both groups. The first-attempt success rates of cannulation were similar (70% vs 73.3%) in both groups, with an overall success rate of 88%. Conclusion: Right internal jugular vein revealed a varying position with respect to carotid artery with a higher rate of lateral position. The presence of such anatomical variation requires ultrasonographic evaluation prior to interventions and real-time guidance during interventions involving right internal jugular vein.

Pre-procedural ultrasound-guided evaluation of left internal jugular vein and brachiocephalic vein: Experience on infants <1 year

2020 ◽  
pp. 112972982092569
Author(s):  
Filiz Uzumcugil
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Present Report ◽  
Brachiocephalic Vein ◽  
Complication Rates ◽  
Success Rates ◽  
Left Internal Jugular Vein ◽  
Ultrasound Guided ◽  
First Choice ◽  
Plane Technique

Pre-procedural evaluation of central veins prior to cannulation with ultrasound is essential to reduce the complication rates as well as to increase the success rates. The left brachiocephalic vein has been suggested to be considered as first choice in infants including the neonates due to its larger diameter and ease of access with supraclavicular, ultrasound-guided, in-plane technique. There are few studies on neonates and infants comparing the diameter of brachiocephalic vein with internal jugular vein being its most common alternative. The aim of the present report is to share our observations pertaining to the pre-procedural measurements of the diameters of left internal jugular vein and brachiocephalic vein in infants <1 year. The measurements were analysed in accordance with the weights of the infants (<2500 g and ⩾2500 g). In infants <2500 g, the brachiocephalic vein was larger than the internal jugular vein (4.0 ± 0.7 (3.2–5.2) mm vs 3.2 ± 0.7 (1.9– 4.3) mm, p = 0.032), whereas the diameters of two major veins were similar in infants ⩾2500 g (4.8 ± 1.2 (2.3–6.4) mm vs 5.1 ± 0.9 (2.8–6.7) mm, p = 0.363). Our observations support the suggestion of the brachiocephalic vein to be considered as the first choice for large-bore cannulation due to its larger diameter as well as its other advantages, especially in neonates <2500 g.

Real-time ultrasound guided placement of temporary internal jugular vein catheters: Assessment of technical success and complication rates in nephrology practice

Nephrology ◽  
2012 ◽  
Vol 17 (7) ◽  
pp. 603-606 ◽  
Author(s):  
HADIM AKOGLU ◽  
SERHAN PISKINPASA ◽  
EZGI C YENIGUN ◽  
RAMAZAN OZTURK ◽  
FATIH DEDE ◽  
...  
Keyword(s):  
Real Time ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Complication Rates ◽  
Technical Success ◽  
Ultrasound Guided

scholarly journals A Study of Malposition of Central Venous Catheter – A Comparative Study between Ultrasound Guided and Anatomical Landmark Technique

2018 ◽  
Vol 2 (3) ◽  
pp. 277-281
Author(s):  
Lalit Kumar Rajbanshi ◽  
Sambhu Bahadur Karki ◽  
Batsalya Arjyal
Keyword(s):  
Real Time ◽  
Internal Jugular Vein ◽  
Subclavian Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Anatomical Landmark ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Catheter Tip ◽  
Landmark Technique

Introduction: Central venous catheterization is a routine procedure for long-term infusion therapy and central venous pressure measurement. Sometimes, the catheter tip may be unintentionally placed at the position other than the junction of superior vena cava and right atrium. This is called malposition and can lead to erroneous pressure measurement, increase risk of thrombosis, venous obstruction or other life threatening complications like pneumothorax, cardiac temponade.Objectives: This study aimed to observe the incidence of the malposition and compare the same between ultrasound guided catheterization and blind anatomical landmark technique.Methodology: This study was a prospective comparative study conducted at the intensive care unit of Birat Medical College and Teaching Hospital for two-year duration. All the catheterizations were done either with the use of real time ultrasound or blind anatomical landmark technique. The total numbers of central venous catheterization, the total incidences of malposition were observed. Finally the incidences were compared between real time ultrasound guided technique and blind anatomical landmark technique.Results: In two-year duration of the study, a total of 422 central venous cannulations were successfully done. The real time ultrasound was used for 280 cannulations while blind anatomical landmark technique was used for 162 patients. The study observed various malposition in 36 cases (8.5%). The most common malposition was observed for subclavian vein to ipsilateral internal jugular vein (33.3%) followed by subclavian to subclavian vein (27.8%) and internal jugular to ipsilateral subclavian vein (16.7%). In four patients the catheter had a reverse course in the internal jugular vein while the tip was placed in pleural cavity in three cannulations. There was coiling of the catheter inside left subclavian vein in one patient. The malposition was significantly reduced with the use of the real time ultrasound (P< 0.001). However there is no significant difference in the incidence of the various malposition between ultrasound guidance technique and blind anatomical landmark technique when compared individually.Conclusion: The malposition of the central venous catheter tip was common complication with the overall incidence of 8.5%. The most common malposition was subclavian vein to internal jugular vein. The use of real time ultrasound during the catheterization procedure can significantly reduced the risk of malposition.Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 277-281

Safely repositioning dual-lumen ECMO cannulas with a transfemoral lasso snare

Perfusion ◽  
2020 ◽  
pp. 026765912096903
Author(s):  
Erika R O’Neil ◽  
Ryan D Coleman ◽  
Adam M Vogel ◽  
Corey A Chartan ◽  
Kamlesh U Kukreja
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Real Time ◽  
Internal Jugular Vein ◽  
Pediatric Patients ◽  
Jugular Vein ◽  
Limb Ischemia ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
The Right ◽  
Fluoroscopy Guidance ◽  
Vv Ecmo

Introduction: Dual-lumen cannulas were designed to provide venovenous extracorporeal membrane oxygenation (VV ECMO) with single-vessel access. Anatomic and size considerations may make appropriate placement challenging in children. Dual-lumen cannulas are repositioned in 20–69% of pediatric patients, which can be difficult without transient discontinuation of ECMO support. Methods: We repositioned three dual-lumen ECMO cannulas introduced via the right internal jugular vein using a transfemoral snare technique under real-time ultrasound and fluoroscopy. Results: Two of three patients were supported on VV ECMO and one on veno-veno-arterial (VV-A) ECMO. Two of the three patients had their dual-lumen cannula repositioned under ultrasound and fluoroscopy guidance and one was repositioned just with ultrasound. No patient experienced a complication from the transfemoral snare technique such as femoral hematoma, hemorrhage or limb ischemia. Conclusion: We describe three patients who successfully had dual-lumen cannulas repositioned without cessation of ECMO using a transfemoral “lasso” technique.

scholarly journals Variations in the anatomical relationship between the common carotid artery and the internal jugular vein: An ultrasonographic study

2015 ◽  
pp. 54-59 ◽  
Author(s):  
Mauricio Umaña Perea ◽  
Alberto Federico García ◽  
José Luis Castillo García ◽  
Luis Alfonso Bustamante Cristancho ◽  
Juan Sebastián Martínez Collazos
Keyword(s):  
Multivariate Analysis ◽  
Carotid Artery ◽  
Internal Jugular Vein ◽  
Common Carotid Artery ◽  
Jugular Vein ◽  
Patients Âgés ◽  
Anterior Position ◽  
Anatomical Relationship ◽  
The Common ◽  
The Right

Introduction: The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a rotated position. Aim: To identify variables associated with the anterior location of the internal jugular vein. Methods: Ultrasound examinations were performed with the patients in the supine position, with the head rotated to the opposite side. The proximal third of the neck was visualized transversely with a 7.5-mHz transducer. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein. Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed. Results: Seventy-eight patients were included, 44 of whom were men. The patients' ages ranged from 17 to 90 years (median 64.0, interquartile range 41-73). The right and left sides were studied 75 and 73 times, respectively. The vein was located lateral to the artery in 24.3% (95%CI= 17.4-32.2) of the studies, anterolateral in 33.8% (95%CI= 26.2-41.4) and anterior in 41.9% (95%CI= 33.9-49.8). The multivariate analysis identified age group (OR= 3.7, 95% CI 2.1-6.4) and, less significantly, the left side (OR= 1.7, 95%CI= 0.8-3.5) and male gender (OR= 1.2, 95%CI= 0.6-2.7) as variables associated with the anterior position of the vein. Conclusión: The anterior position of the internal jugular vein relative to the common carotid artery increases gradually with age. Additionally, left-sided localization and male sex further increased the probability of an anterior position.

scholarly journals The Influence of the Univent® Endotracheal Tube on Internal Jugular Vein Cannulation

2005 ◽  
Vol 33 (1) ◽  
pp. 82-86 ◽  
Author(s):  
W. Schummer ◽  
C. Schummer ◽  
R. Frober ◽  
J. Fuchs ◽  
M. Simon ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Endotracheal Tube ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Clinical Investigation ◽  
Lateral Displacement ◽  
Left Internal Jugular Vein ◽  
Jugular Veins ◽  
Cross Sectional ◽  
The Right

This prospective clinical investigation assessed the effect of placement of a Univent® tube on the anatomy of the internal jugular veins and the success of cannulation of the left internal jugular vein. After obtaining informed consent, 48 adult patients were enrolled. Of these, 42 patients were eligible and were divided into two groups: Univent® tube (group U, n=21) and wire enforced endotracheal tube (group C, n=21). The Univent® tube group were having a left thoracotomy. Using horizontal ultrasound scans just above the thyroid gland, the internal jugular vein was visualized and measured before and after Univent® placement. The number of needle passes necessary to cannulate the left internal jugular vein in the two groups was also compared. Univent® tubes were associated with lateral displacement of the right carotid artery and internal jugular vein on the convex side of the Univent® tube, with compression of the right internal jugular vein by the artery, resulting in a kidney-shaped cross-section of the vein. On the left (concave side of the tube), the neck was indented, the sheath of the left carotid artery was displaced medially, and the left internal jugular vein distorted to an ellipse. There was a significant increase in the lateral diameter and a decrease in the cross-sectional area of the left internal jugular vein (t-test, P<0.05). The first attempt at cannulation of the left internal jugular vein failed significantly more often in the Univent® group (13/21 vs 5/21 in group C, Chi-square 6.22, P=0.025). Cannulation of the internal jugular vein before placement of the Univent® tube, or placement with ultrasound guidance is suggested.

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