scholarly journals COMPARISON OF CENTRAL VENOUS CANNULATION OF RIGHT INTERNAL JUGULAR VEIN BY LANDMARK BASED APPROACH AND REAL-TIME ULTRASOUND GUIDED CANNULATION IN CRITICAL CARE PATIENTS.

2017 ◽  
Vol 5 (4) ◽  
pp. 923-926
Author(s):  
Nusrat Jehan ◽  
◽  
MudasirMohammad Rangraiz ◽  
Mubasher Ahmad ◽  
◽  
...  
2016 ◽  
Vol 6 (3) ◽  
Author(s):  
Mehdi Fathi ◽  
Azra Izanloo ◽  
Saeed Jahanbakhsh ◽  
Mehryar Taghavi Gilani ◽  
Ali Majidzadeh ◽  
...  

2017 ◽  
Vol 5 (1) ◽  
pp. 68-69
Author(s):  
Gentle S Shrestha ◽  
Bashu Dev Parajuli ◽  
Amit Sharma Bhattarai

Central venous cannulation is a commonly performed procedure in ICU. Even in the experienced hands, it is not free of complications. Acute mechanical adverse events are more likely in agitated and uncooperative patients. Ultrasound guided cannunation of internal jugular vein is associated with higher success rate and fewer mechanical complications when compared with traditional techniques. Dexmedetomidine has been used as a safe and effective agent for procedural sedation in a wide variety of patients. Here we successfully used dexmedetomidine for ultrasound guided central venous cannulation of internal jugular vein in uncooperative high risk patients, even at the extremes of age.Bangladesh Crit Care J March 2017; 5(1): 68-69


2018 ◽  
Vol 2 (3) ◽  
pp. 277-281
Author(s):  
Lalit Kumar Rajbanshi ◽  
Sambhu Bahadur Karki ◽  
Batsalya Arjyal

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


2016 ◽  
Vol 3 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Santosh Sharma Parajuli ◽  
Jeju Nath Pokharel

Background: Catheterization of internal jugular vein can be achieved by either anatomical landmark technique or the ultrasound guided technique. The objective of our study is to find out if ultrasound guided technique could be beneficial in placing central venous catheters by improving the success rate by reducing the number of attempts, decreasing the access time and decreasing the complications rate in comparison to the landmark technique.Methods: Fifty patients scheduled for cardiac surgery requiring central venous cannulation of the right internal jugular vein were divided into two groups: ultrasound guided group ‘U’ and the landmark group ‘L’, each consisting of 25 patients with age more than 15 years. The outcomes were compared in terms of success rate, time taken for successful cannulation and rate of complications.Results: The two groups were comparable in terms of age, weight, heart rate and blood pressure. The mean number of attempts for successful cannulation was 1.08±0.277 and 1.40±0.764 (p=0.055), the time taken in seconds for successful cannulation was 108.56±27.822 and 132.08±72.529 (p=0.137) and the overall complication rate was 0% (0 out of 25) and 32% (8 out of 25) (p=0.02) in the ultrasound guided and the landmark technique group respectively.Conclusion: Ultrasound guided central venous catheterization of internal jugular vein is comparable to the landmark technique in terms of number of attempts and the time required for successful cannulation. Ultrasound guided technique is much safer than the landmark technique to reduce the overall complications rate during central venous cannulation.


Introduction: Portal hypertension leads to dilation of internal mammary veins. Among the various sites of misplacement of a catheter inserted via the internal jugular vein, misplacement in the internal mammary vein is relatively rare in the general population, when compared to liver disease patients. Catheter misplacement during central venous cannulation can be associated with thrombosis, wedging, erosion, and perforation. The option of replacing or removing the catheter is not always risk-free, particularly with associated coagulopathy. We describe the management of a misplaced CVC which was accessed through the left internal jugular vein and repositioned under fluoroscopic guidance. Keywords: Central venous catheter, Repositioning of central venous catheter, central venous catheter in left internal mammary vein, portal hypertension, fluoroscopy


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