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

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.

scholarly journals Ultrasound-guided central venous tip confirmation via right external jugular vein using a right supraclavicular fossa view

2018 ◽  
Vol 20 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Mariko Kosaka ◽  
Yoshimasa Oyama ◽  
Tetsuya Uchino ◽  
Yojiro Ogihara ◽  
Hironori Koga ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Jugular Vein ◽  
Venous Catheter ◽  
External Jugular Vein ◽  
Central Venous Catheter Insertion ◽  
Ultrasound Guided ◽  
Central Venous ◽  
X Ray ◽  
Supraclavicular Fossa ◽  
Catheter Tip

Introduction: Ultrasound-guided central venous catheter tip confirmation has a potential to precisely locate the central venous catheter, preventing its misplacement, using real-time guidance. This observational study sought to determine the accuracy of central venous catheter tip positioning via the external jugular vein via a supraclavicular fossa view under ultrasound guidance. Methods: In total, 77 patients scheduled for central venous catheter insertion via the right external jugular vein were enrolled. The depth of central venous catheter insertion was determined by advancing the tip of the guidewire to the junction of the superior vena cava and right pulmonary artery, using a right supraclavicular fossa view ultrasound method. We determined the reference insertion depth to the carina using a postoperative chest x-ray photograph method. We then compared insertion depths obtained by the ultrasound and x-ray photograph methods and body-height formula. Results: In total, 62 patients were able to advance the guidewire and underwent ultrasound-guided central venous catheter insertion. In four patients, we corrected for misplaced guidewires. According to Bland–Altman plots, the insertion depth was 0.88 cm shorter for the ultrasound method (95% limits of agreement, −1.66 to 3.41 cm) and 0.90 cm shorter for the formulaic method (95% limits of agreement, −2.77 to 4.56 cm), compared with the x-ray photograph method. The x-ray photograph method had significantly positive correlations with the ultrasound (r = 0.73) and formulaic methods (r = 0.27). Conclusion: A right supraclavicular fossa view improves the accuracy of central venous catheter tip positioning and prevents central venous catheter misplacement via the right external jugular vein.

scholarly journals Malposition of Central Venous Catheter Inserted under Ultrasound Guidance in Intensive Care Unit: A Case Series

2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Niraj Kumar Keyal ◽  
Sumal Thapa ◽  
Pooja Adhikari ◽  
Sanjeeb Yadav
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Patient Management ◽  
Ultrasound Guidance ◽  
Jugular Vein ◽  
Case Series ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip

Malposition of central venous catheter tip inserted into the subclavian and internal jugular vein is a rare unavoidable complication that can be decreased if inserted under ultrasound guidance. We report case series of three patients, two of subclavian and another of internal jugular inserted central venous catheter, in which the catheter malpositioned into ipsilateral internal jugular and subclavian vein respectively but had no effect on patient management. From this, we want to emphasize that the effect of malposition of central venous catheter tip depends upon the indication for which central venous catheter was inserted; it can be detected bedside by ultrasound and flush test.

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

scholarly journals A Novel Objective Approach Towards Physicians' Knowledge and Practice Patterns to Optimize Central Venous Catheter Placement: A Cross-sectional Study

2020 ◽  
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Clinical Practices ◽  
Central Venous ◽  
Cross Sectional ◽  
Study Objective ◽  
Catheter Tip

Study objective: Central venous catheterization is an essential component of intensive care of critically ill patients, and proper positioning of the catheter is essential to prevent position-related complications. This study was conducted by using digital tape measurement to objectively assess clinician preferences for central venous catheter positioning based on specific position levels and landmarks on post-procedural chest radiographs. Design: A cross-sectional study using electronic questionnaire survey. Setting: Single academic teaching hospital participated in this study. Participants: The study enrolled 276 physicians from multiple clinical disciplines. Interventions: None. Measurements: A seven-level reference system labeled on a sample chest radiograph was used to identify the acceptable lower and upper limits and landmarks used to determine the optimal central venous catheter tip position as well as the pattern of clinical practices based on the specialty and level of experience of participants. Main results: Among the 276 respondents, the ratio of cumulative acceptance for the lower and upper catheter tip limit was 62% and 66.3% within a 4-cm range below or above the carina, respectively. Intensive care unit (ICU) physicians showed a greater tendency to choose a catheter tip 4 cm below and 6 cm above the carina (p = 0.004 and 0.002, respectively) as did experienced physicians (p = 0.007 and < 0.001, respectively). The commonest reason for catheter tip withdrawal was arrhythmia (50% of cases). Physicians in the ICU and experienced physicians were more concerned about the risk of cardiac perforation than other respondents (p < 0.001 and < 0.001, respectively). The carina was the most commonly used landmark in 71.7% of all physicians, although 50% of radiologists also used other landmarks. Conclusions: The acceptable limit of the catheter tip is 4 cm above and below the carina (-4 to +4), as determined on chest radiography, without a need for tip adjustment.

scholarly journals Malposition of central venous catheter in the jugular venous arch via external jugular vein -a case report-

2015 ◽  
Vol 68 (2) ◽  
pp. 175
Author(s):  
SoWoon Ahn ◽  
Ju Ho Lee ◽  
Chunghyun Park ◽  
Yong-woo Hong ◽  
Duk-Hee Chun
Keyword(s):  
Case Report ◽  
Central Venous Catheter ◽  
Jugular Vein ◽  
Venous Catheter ◽  
External Jugular Vein ◽  
Central Venous

scholarly journals Comparison of mechanical complications of central venous catheter according to the insertion site in an intensive care unit of Bangladesh

2020 ◽  
Vol 10 (2) ◽  
pp. 115-119
Author(s):  
Debasish Kumar Saha ◽  
Suraiya Nazneen ◽  
ASM Areef Ahsan ◽  
Madhurima Saha ◽  
Kaniz Fatema ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Insertion Site ◽  
Venous Catheter ◽  
Arterial Puncture ◽  
Central Venous ◽  
Femoral Site ◽  
Mechanical Complications ◽  
Catheter Tip

Background: Central venous catheter (CVC) insertion is very common in intensive care unit (ICU). CVC is usually inserted in subclavian, internal jugular and femoral veins. However, CVC insertion may lead to significant mechanical complications. Our aim was to detect the occurrence of CVC related mechanical complications according to different insertion site. Methods: This prospective observational study was carried out during the period of May 2016 to July 2019 in Department of Critical Care Medicine, BIRDEM General Hospital, Dhaka, enrolling 349 adult patients requiring new CVC insertion in ICU. Results: Among 349 study subjects, 167 CVC were inserted through subclavian vein, 88 through internal jugular and 94 through femoral vein. There was no significant difference among three groups (subclavian / internal jugular / femoral) in terms of age, gender distribution, presence of co-morbid illness.Total mechanical complicationsin study population was 43 (12.3 %) including pneumothorax (14, 4.0%), arterial puncture (10, 2.9%), hemorrhage (11, 3.2%), catheter tip malposition (6, 1.7%), hemothorax (1, 0.3%) and lost guidewire (1, 0.3%). Pneumothorax was more with internal jugular (9.1%) than subclavian (3.6 %) route, which was statistically significant (p=0.007). Although hemorrhage and arterial puncture events were higher with femoral site than subclavian or internal jugular, which were not significant. Catheter tip malposition occurred in 4 (2.4%) patients with subclavian insertion and 2 (2.3%) patients with internal jugular site, no such event in femoral site. Hemothorax and lost guidewire occurred in only 1 patient with subclavian and internal jugular site respectively. Site-wise total mechanical complications were higher in internal jugular (17.0%) followed bysubclavian (10.8%) site and femoral site (10.6%). Conclusion: In this study, though not statistically significant, CVC related mechanical complications occurred more in subclavian site than in internal jugular or femoral insertion site. Birdem Med J 2020; 10(2): 115-119

scholarly journals Cannulation of the lateral saphenous vein-a rapid method to gain access to the venous circulation in anaesthetized guineapigs

1993 ◽  
Vol 27 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Roland Nau ◽  
Ortwin Schunck
Keyword(s):  
Surgical Intervention ◽  
Jugular Vein ◽  
Present Report ◽  
Vena Cava ◽  
Venous Access ◽  
External Jugular Vein ◽  
Venous Circulation ◽  
Venous Puncture ◽  
Teflon Catheter ◽  
Gain Access

Previously published methods of venous puncture in guineapigs did not provide reliable venous access for more than a few minutes, and therefore surgical intervention was necessary to cannulate the femoral or external jugular vein or the vena cava. In the present report cannulation of the Vena saphena lateralis via the Vena plantaris lateralis or of the Vena saphena medialis is described by inserting a 22 gauge teflon catheter. These catheters are commercial products. The method is timesaving and inexpensive. Successful cannulation was accomplished in 34 of 35 guineapigs. No lethal incidents occurred.

scholarly journals Horner`s Syndrome after internal jugular vein catheterization: a case report.

2021 ◽  
Author(s):  
Pedro Vinicius Brito Alves ◽  
Coralia Gabrielle Vieira Silveira ◽  
Jorge Fernando de Miranda Pereira ◽  
Isabela Fonseca Risso ◽  
Paulo Eduardo Lahoz Fernandez ◽  
...  
Keyword(s):  
Intensive Care ◽  
Case Report ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Anticholinergic Drugs ◽  
Carotid Dissection ◽  
Common Procedure ◽  
Cerebral Herniation ◽  
Critical Patients

Context: Central venous catheterization of the internal jugular vein is a common procedure that can be complicated with Horner`s Syndrome, caused by a direct lesion of cervical sympathetic pathways, pneumothorax compression, or carotid dissection. This entity should be considered when assessing new anisocoria in intensive care scenarios. Case Report: We report the case of a 64-year-old woman, who presented anisocoria during an intensive care unit hospitalization. She had been admitted with severe COVID-19 and need for mechanical ventilation. Her anisocoria was more evident in the dark, with right miosis, ipsilateral semi-ptosis, and preserved photoreaction reflexes. Before the anisocoria, she had a venous catheter inserted in her right jugular vein. Further evaluation showed a right pneumothorax, which was promptly drained after the mispuncture. The cervical arterial angiotomography showed no signs of carotid dissection. Conclusion: New anisocoria in critical patients is usually associated with impairment of the parasympathetic tonus, either by the use of topic or inhalatory anticholinergic drugs or cerebral herniation syndrome. However, in these situations, the anisocoria is more appreciable in light, with disruption of photoreaction in the greater pupil and ipsilateral ptosis. Therefore, we believe our patient developed an iatrogenic Horner`s Syndrome, secondary to a catheterization mispuncture, leading to a direct lesion of sympathetic pathways and their compression by the pneumothorax. Beyond parasympathetic pharmacologic blockade or cerebral herniation, Horner`s Syndrome constitutes a valuable differential diagnosis when evaluating patients with new anisocoria in the ICU.

scholarly journals The “branching external jugular vein”: an unreported clinically significant anatomic variation

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Mohamed Sameh Shalaby
Keyword(s):  
Success Rate ◽  
Clinical Relevance ◽  
Jugular Vein ◽  
Anatomic Variation ◽  
Venous Catheter ◽  
Anatomical Variations ◽  
External Jugular Vein ◽  
Anterior Branch ◽  
The Times ◽  
The Right

Abstract Background The reported overall success rate for central venous catheter (CVC) insertion into the external jugular vein (EJV) is less than other central veins. A contributing factor for this might be the well-documented anatomical variations of the EJV. However, there are no reports correlating these anatomical variations with successful CVC insertion. Our aim was to evaluate the EJV anatomical variations and their clinical relevance. Results All CVCs inserted over the study period were prospectively recorded with emphasis on the times the EJV was accessed, operative difficulties and any anatomical variations with their influence on CVC insertion. Over 15 months, 36 CVCs were inserted, 17 (47%) into EJV. For EJV line insertions, age is 39 days–14 years, 9 into right EJV. Operative difficulty was encountered in 4 patients (24%) where the catheter was inserted into EJV but failed to thread into a satisfactory position. In all 4 patients, further dissection revealed EJV branching into a bigger anterior branch which follows the course of main EJV yet not leading to the right atrium (RA) and a smaller posterior branch leading to RA. Regarding the 4 cases of “the branching EJV”, age is 2–14 years, 3 males:1 female and 3 left:1 right EJV. The overall success rate for CVC insertion through the EJV in this study was 100% including the 4 cases with “the branching EJV”. Conclusions This is the first report describing “the branching EJV” and its clinical relevance to CVC insertion.

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