scholarly journals Ultrasound guided versus land mark technique for internal jugular central venous catheterization in cardiac surgical patients- a randomized trial

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.

2021 ◽  
Vol 6 (3) ◽  
pp. 204-207
Author(s):  
Shallu Chaudhary ◽  
Major Amit Atwal

Central venous catheterization is a standard procedure used in the resuscitation of critically ill patients. There are different routes of CVP insertion which are:- subclavian vein, internal jugular vein, axillary vein and femoral vein. Each route has its own set of complications like artery puncture, pneumothorax, nerve injury, infections. Initially catheters were inserted by the landmark technique using guidewire through the needle commonly called seldinger technique. The landmark technique is found to be associated with a higher range of mechanical complications. The use of USG however has proved to improve the success rate and decrease the complications. Keywords: Central venous catheterization, resuscitation, internal jugular vein.


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


2021 ◽  
pp. 112972982110403
Author(s):  
Alessandro Strumia ◽  
Ferdinando Longo ◽  
Lorenzo Schiavoni ◽  
Matteo Martuscelli ◽  
Francesca Claps ◽  
...  

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