scholarly journals Comparison of three different techniques for internal jugular vein cannulation under real time ultrasound guidance

2021 ◽  
Vol 8 (2) ◽  
pp. 129
Author(s):  
Reena Mahajan ◽  
Suchitra Malhotra
Keyword(s):  
Success Rate ◽  
Real Time ◽  
Traditional Approach ◽  
Venous Access ◽  
Access Time ◽  
Internal Jugular Vein Cannulation ◽  
Successful Cannulation ◽  
Number Of Patients ◽  
Cannulation Success Rate ◽  
Cannulation Success

<p><strong>Background: </strong>Ultrasound (USG) guided Internal jugular venous (IJV) cannulation is preferred than traditional approach due to increase in success rate, reduction in time taken and attempts of successful cannulation and less complications. The purpose of our study was to observe and compare three different real time 2-dimensional US-guided approaches and to determine which approach improves rate of successful cannulation, decreases complications along with shorter average time taken for the procedure. Primary outcomes of the study were venous access time, catheterization time and success rate. Secondary outcomes were number of patients requiring second attempt and complications observed.</p><p><strong>Methods: </strong>120 adult patients were randomly divided into three groups according to real time US guided cannulation done with SAX-OP approach, LAX-IP approach and OAX-IP approach. Parameters like venous access time, catheterization time, number of patients requiring second attempt and complications were noted.</p><p><strong>Results: </strong>Venous access time was shortest in LAX group 21.84±3.67 seconds which was just significant statistically. Catheterization time was shortest in LAX group 241±123 seconds. Cannulation success rate was highest in LAX group 98% and was statistically significant. Patients requiring second attempt was least in LAX group 2.5%. Posterior IJV wall puncture was observed in 10% patients in SAX group and none in LAX and OAX group which was statistically significant.</p><p><strong>Conclusions:</strong> LAX-IP showed better performance in terms of higher cannulation success, lesser average venous access time and catheterization time and lesser complications. On toggling USG probe, both IJV and carotid artery can be differentiated and carotid puncture could be avoided. Hence LAX approach is safer and effective approach.</p>

Evaluation of the AirgloveTM, An Air-Regulated Thermal-Venodilatory Device Facilitating the Cannulation of Patients With Difficult Venous Access

2021 ◽  
Author(s):  
Leon Gerard D'Cruz ◽  
Elaine Gardiner ◽  
Priyank Shukla ◽  
Dianne M. Dickson ◽  
Tiago M. Malaquias ◽  
...  
Keyword(s):  
Success Rate ◽  
Water Immersion ◽  
Venous Access ◽  
Cross Sectional ◽  
Percentage Body Fat ◽  
Array Transducer ◽  
Cubital Fossa ◽  
Cannulation Success Rate ◽  
Cannulation Success ◽  
Difficult Venous Access

Abstract Background Difficult venous access (DVA) can prevent delivery of life-saving intravenous (IV) fluids and medication. The Airglove™ was developed to facilitate IV access, circumventing DVA in chemotherapy patients, as current warm-water immersion (WWI) methods are sub-optimal. Methods This study had two parts; EAGLE-1, an observational, proof-of-concept study and EAGLE-2, a prospective, cross-sectional comparative study. EAGLE-1 recruited 80 adult participants undergoing chemotherapy for cancer with DVA where venous cannula insertion success rate was evaluated using Airglove™. EAGLE-2 was carried out on 34 adult healthy participants where the degree of venodilation by WWI and AirGlove™ in three veins; cubital-fossa cephalic vein, cubital-fossa median vein and the third dorsal carpal vein on both arms were measured using the GE Logic S8 multi-frequency linear-array transducer (L6-15MHz), two-dimension B-mode ultrasound. Baseline measurements were taken at 23oC, forearms were warmed to 38oC using the two modalities prior to ultrasound assessment. Results An IV cannulation success-rate of 87.5% was achieved with the Airglove™ in EAGLE-1. The EAGLE-2 study demonstrated significant venodilation enhancement in all veins examined (p < 0.001, 95% C.I) using the Airglove™. BMI, percentage body-fat, age, gender, or blood-pressure did not significantly influence the degree of venodilation. Conclusions Airglove™ enabled a significant percentage of successful cannulations in participants with DVA in EAGLE-1. EAGLE-2 demonstrated that Airglove™ significantly enhanced venodilation compared to WWI. There may be potential for Airglove™ to be considered in specific clinical settings where DVA is encountered.

scholarly journals Subclavian Vein Cannulation Success Rate in Neonates and Children

2015 ◽  
Vol 5 (3) ◽  
Author(s):  
Reza Aminnejad ◽  
Seyed Sajjad Razavi ◽  
Seyed Amir Mohajerani ◽  
Seyed Alireza Mahdavi
Keyword(s):  
Success Rate ◽  
Subclavian Vein ◽  
Vein Cannulation ◽  
Cannulation Success Rate ◽  
Cannulation Success

scholarly journals Echogenic Technology Improves Cannula Visibility during Ultrasound-Guided Internal Jugular Vein Catheterization via a Transverse Approach

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Konstantinos Stefanidis ◽  
Nicos Pentilas ◽  
Stavros Dimopoulos ◽  
Serafim Nanas ◽  
Richard H. Savel ◽  
...  
Keyword(s):  
Real Time ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Central Venous Access ◽  
Randomized Study ◽  
Venous Access ◽  
Access Time ◽  
Ultrasound Guided ◽  
Bootstrap Analysis ◽  
Mechanical Complications

Objective.Echogenic technology has recently enhanced the ability of cannulas to be visualized during ultrasound-guided vascular access. We studied whether the use of an EC could improve visualization if compared with a nonechogenic vascular cannula (NEC) during real-time ultrasound-guided internal jugular vein (IJV) cannulation in the intensive care unit (ICU).Material and Methods.We prospectively enrolled 80 mechanically ventilated patients who required central venous access in a randomized study that was conducted in two medical-surgical ICUs. Forty patients underwent EC and 40 patients were randomized to NEC. The procedure was ultrasound-guided IJV cannulation via a transverse approach.Results.The EC group exhibited increased visibility as compared to the NEC group (88%  ± 8% versus 20%  ± 15%, resp.P<0.01). There was strong agreement between the procedure operators and independent observers (k=0.9; 95% confidence intervals assessed by bootstrap analysis = 0.87–0.95;P<0.01). Access time (5.2 s ± 2.5 versus 10.6 s ± 5.7) and mechanical complications were both decreased in the EC group compared to the NEC group (P<0.05).Conclusion.Echogenic technology significantly improved cannula visibility and decreased access time and mechanical complications during real-time ultrasound-guided IJV cannulation via a transverse approach.

scholarly journals A Randomized Controlled Trial of Radial Artery Cannulation Guided by Modified Long Axis Ultrasound Versus Short Axis Ultrasound Versus Palpation

2020 ◽  
Author(s):  
Jiebo Wang ◽  
Liangcheng Zhang ◽  
Zisong Zhao ◽  
Zhongmeng Lai ◽  
Qijian Huang ◽  
...  
Keyword(s):  
Success Rate ◽  
Radial Artery ◽  
Controlled Trial ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Radial Artery Cannulation ◽  
Artery Cannulation ◽  
Out Of Plane ◽  
Cannulation Success Rate ◽  
Cannulation Success

Abstract Background: Given the low first-pass success rate of the conventional short-axis (SAX) or long-axis (LAX) approach, ultrasound-guided radial artery cannulation in adults with radial artery diameters less than 2.2 mm may still be challenging. In this study, we compare the efficacy of modified long-axis in-plane(M-LAIP) versus short-axis out-of-plane (SAOP) or conventional palpation(C-P) approaches for ultrasound-guided radial artery cannulation.Methods: This was a prospective, randomized and controlled trial, conducted from 1 July 2018 to 24 November 2018. A total of 201 patients (age 18 to 85 years, the diameter of the radial artery less 2.2 mm) were included. All patients were randomized 1:1:1 to the M-LAIP, SAOP or conventional palpation (C-P) approach. The primary outcome was the cannulation success rate. Secondary outcomes included first location time and cannulation time, number of attempts. The Chi-square (χ2) test was used to compare categorical data between 3 groups.Results: The cannulation success rate was significantly higher in the M-LAIP group than in the SAOP or C-P groups (first success rate: 80.3% vs 53.8% or 33.8%; p < 0.001; total success rate: 93.9% vs 78.5% or 50.8%; p < 0.001). First location time (seconds) was significantly longer in the M-LAIP group (31(28-35[12-44])) than in the SAOP (15(14-17[10-21]); p < 0.001) and C-P groups (12(8-13.5 [6-37]). However, the cannulation time (seconds) in the M-LAIP group (29(24-45[16-313])) was significantly shorter than that in the SAOP (45(28.5-135.5[14-346]); p = 0.002) and the C-P groups (138(27-308[12-363]); p < 0.001). The number of attempts was lower in the M-LAIP group compared with SAOP or C-P group (1.29±0.63 vs 1.8±0.89 or 2.22±0.93, p < 0.001).Conclusions: The use of the M-LAIP approaches significantly improved the success rate of radial artery cannulation in adults with radial artery diameters less than 2.2 mm, compared with that achieved with the use of traditional short-axis out-of-plane approach.Trial registration: ClinicalTrials.gov; No: ChiCTR-IOR-17011474; URL: http: // www. chictr.org. cn/index.aspx. Registered 24 June 2018.

scholarly journals Impact of Periampullary Diverticulum on Biliary Cannulation and ERCP Outcomes: A Single-Center Prospective Study

2020 ◽  
Author(s):  
Fatema Tabak ◽  
Guo-Zhong Ji ◽  
Lin Miao
Keyword(s):  
Adverse Events ◽  
Success Rate ◽  
Biliary Cannulation ◽  
Periampullary Diverticulum ◽  
Group A ◽  
Group B ◽  
Cannulation Success Rate ◽  
Cannulation Success ◽  
Selective Cannulation ◽  
The Impact

Aim: This study aimed to investigate the association between periampullary diverticulum (PAD) and difficult biliary cannulation, as well as to evaluate the impact of different types of PAD on the cannulation success rate and adverse events. Methods: A total of 636 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) during the study period were prospectively studied and divided into two groups based on the presence or absence of PAD. In group A, 126 patients had PAD compared with 510 patients in group B without PAD. The primary outcome measurements were ERCP procedures time, selective cannulation techniques, and cannulation difficulty in addition to cannulation success rate and ERCP-related adverse events. The difficult cannulation was analyzed using logistic regression considering age, co-morbidities, the presence of PAD types, and indications as independent factors. Results: The average cohort age was 65.30&plusmn;16.67 years, and 52.7% were male. Significant higher rates of choledocholithiasis, cholangitis, and biliary pancreatitis were reported in the group of PAD (p&lt;0.05). Successful selective cannulation was achieved in 97.6% in group A and 95.3% in group B (p&gt;0.05). The cannulation time was significantly longer in the presence of PAD (5.1 min, vs. 4.09 min, p&lt;0.05). There was no significant difference in the rate of overall adverse events and post ERCP pancreatic PEP. Conclusion: The presence of PAD did not affect the duration or success of the ERCP procedure. Furthermore, it was associated with longer cannulation time and increase in the cannulation difficulty, especially with PAD type 1.

scholarly journals Modified Long-Axis In-Plane Ultrasound Versus Short-Axis Out-of-Plane Ultrasound For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

2019 ◽  
Author(s):  
Jiebo Wang ◽  
Liangcheng Zhang ◽  
Qijian Huang ◽  
Zhongmeng Lai ◽  
Guohua Wu ◽  
...  
Keyword(s):  
Success Rate ◽  
Radial Artery ◽  
Controlled Trial ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Radial Artery Cannulation ◽  
Artery Cannulation ◽  
Out Of Plane ◽  
Cannulation Success Rate ◽  
Cannulation Success

BACKGROUNDGiven a low first-pass success rate of the conventional SAX (short-axis) or LAX (long-axis) approach, ultrasound-guided radial artery cannulation in adults with radial artery diameter less than 2.2 mm may be still challenging.OBJECTIVETo assess the efficacy of modified long-axis in-plane(M-LAIP) versus short-axis out-of-plane (SAOP) or conventional palpation(C-P) approaches for ultrasound-guided radial artery cannulation.DESIGNA prospective, randomized and controlled trial.SETTINGOperating room in a tertiary university hospital, from 1 July 2018 to 24 November 2018.PATIENTSA total of 201 patients (age 18 to 85 years, the diameter of the radial artery less 2.2 mm) were included. Patients with history of forearm surgery, ulnar artery occlusion, abnormal Allen test, etc, were excluded from this study.INTERVENTIONSAll patients were randomized 1:1:1 to M-LAIP, SAOP or C-P.MAIN OUTCOME MEASURESThe primary outcome was the cannulation success rate. Secondary outcomes included first location time and cannulation time, number of attempts.RESULTSThe cannulation success rate was significantly higher in the M-LAIP group than in the SAOP group or C-P group (first success rate: 80.3% vs 53.8% or 33.8%; p =0.000; total success rate: 93.9% vs 78.5% or 50.8%; p =0.000). First location time (s) was significantly longer in the M-LAIP group compared with the SAOP group (31(28-35[12-44]) vs 15(14-17[10-21]); p =0.000) and the C-P group (31(28-35[12-44]) vs 12(8-13.5 [6-37]); p =0.000). However, the time of cannulation in the M-LAIP group (29(24-45[16-313])) was significantly shorter than that in the SAOP group (45(28.5-135.5[14-346]), p =0.002) and in the C-P group(138(27-308[12-363]), p =0.000). The number of attempts decreased in the M-LAIP group compared with SAOP or C-P group (1.29±0.63 vs 1.8±0.89 or 2.22±0.93, p =0.000).CONCLUSIONThe M-LAIP procedure for ultrasound-guided radial artery cannulation can offer a higher success rate of the first-attempt and total cannulation, fewer attempts and less time of cannulation.TRIAL REGISTRATIONThe study was registered at ClinicalTrials.gov (http://www.chictr.org.cn/index.aspx, number: ChiCTR-IOR-17011474).

scholarly journals Impact of Periampullary Diverticulum on ERCP Papillary Cannulation

2020 ◽  
Author(s):  
Fatema Tabak ◽  
Guo-Zhong Ji ◽  
Lin Miao
Keyword(s):  
Adverse Events ◽  
Success Rate ◽  
Periampullary Diverticulum ◽  
Group A ◽  
Group B ◽  
Cannulation Success Rate ◽  
Cannulation Success ◽  
Selective Cannulation ◽  
The Impact

Objectives: This study aimed to investigate the association between periampullary diverticulum (PAD) and difficult biliary cannulation, as well as to evaluate the impact of different types of PAD on the cannulation success rate and adverse events. Methods: A total of 636 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) during the study period were prospectively studied and divided into two groups based on the presence or absence of PAD. In group A, 126 patients had PAD compared with 510 patients in group B without PAD. The primary outcome measurements were ERCP procedures time, selective cannulation techniques, and cannulation difficulty in addition to cannulation success rate and ERCP-related adverse events. The difficult cannulation was analyzed using logistic regression considering age, co-morbidities, the presence of PAD types, and indications as independent factors. Results: The average cohort age was 65.30&plusmn;16.67 years, and 52.7% were male. Significant higher rates of choledocholithiasis, cholangitis, and biliary pancreatitis were reported in the group of PAD (p&lt;0.05). Successful selective cannulation was achieved in 97.6% in group A and 95.3% in group B (p&gt;0.05). The cannulation time was significantly longer in the presence of PAD (5.1 min, vs. 4.09 min, p&lt;0.05). There was no significant difference in the rate of overall adverse events and post ERCP pancreatic PEP. Conclusions: The presence of PAD did not affect the duration or success of the ERCP procedure. Furthermore, it was associated with longer cannulation time and increase in the cannulation difficulty, especially with PAD type 1. The presence of PAD did not affect the duration or success of the ERCP procedure. Furthermore, it was associated with longer cannulation time and increase in the cannulation difficulty, especially with PAD type 1.

scholarly journals Application of Precut Papillotomy in Patients With Surgically Altered Gastrointestinal Anatomy

2021 ◽  
Author(s):  
Linlin Yin ◽  
Si Zhao ◽  
Hanlong Zhu ◽  
Guozhong Ji ◽  
Xiuhua Zhang
Keyword(s):  
Adverse Events ◽  
Success Rate ◽  
Standard Method ◽  
Duodenal Papilla ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Duodenal Stricture ◽  
Jejunal Stricture ◽  
Cannulation Success Rate ◽  
Cannulation Success

Abstract It is challenging to perform ERCP (endoscopic retrograde cholangiopancreatography) in patients with surgically altered gastrointestinal anatomy. The failure rate of selective bile duct cannulation by the standard method is high. To explore the application of precut papillotomy (PP) technique in patients with gastrectomy, we carried out this retrospective analysis. From January 2017 to September 2020, 107 patients with surgically altered gastrointestinal anatomy were referred to our department for ERCP examination. Among them, 11 cases were duodenal stricture or jejunal stricture, resulting in the inability to reach the duodenal papilla. Eleven patients stopped cannulation because they could not tolerate the further operation. 60 patients were intubated successfully by standard method. Finally, 25 patients using the precut papillotomy technique were included in our analysis. Of the 25 patients who used pp, 21 completed selective biliary cannulation, with a success rate of 84% (21/25). Compared with standard intubation, the PP technique increased the success rate of intubation in patients with altered anatomy by 21.9%. Among the patients we included, 2 cases had adverse events, including 1 case of acute pancreatitis and 1 case of perforation; the incidence of adverse events was 8%. All adverse events were mild and cured after conservative treatment. In patients with gastrointestinal anatomical changes, PP is effective and relatively safe to improve the selective biliary cannulation success rate.

Sign in / Sign up

Export Citation Format

Share Document