scholarly journals Procedural sedation with dexmedetomidine for ultrasound guided central venous cannulation in agitated, high risk critically ill patients. A series of three cases

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

2016 ◽  
Vol 6 (3) ◽  
Author(s):  
Mehdi Fathi ◽  
Azra Izanloo ◽  
Saeed Jahanbakhsh ◽  
Mehryar Taghavi Gilani ◽  
Ali Majidzadeh ◽  
...  

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


1989 ◽  
Vol 103 (4) ◽  
pp. 424-424 ◽  
Author(s):  
D. W. Sim ◽  
M. R. I. Robertson

AbstractNeurological complications are rare after central venous cannulation. We report a case of right vocal cord paralysis after internal jugular vein cannulation. The mechanism of neural injury is discussed.


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