scholarly journals Ultrasound guided emergency cannulation of internal jugular vein in coagulopathic adult patients – a prospective observational pilot study.

2017 ◽  
Vol 5 (2) ◽  
pp. 93-96
Author(s):  
Gentle Sunder Shrestha ◽  
Sabin Koirala ◽  
Arjun Gurung ◽  
Prakash Chand
Keyword(s):  
Platelet Count ◽  
Real Time ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
International Normalized Ratio ◽  
Adult Patients ◽  
P Value ◽  
Ultrasound Guided ◽  
Margin Of Safety ◽  
The Mean

Aim: This study aims to evaluate the safety of ultrasound guided emergency cannulation of internal jugular vein in coagulopathic adult patients.Methods: Adult subjects admitted in the intensive care unit, undergoing emergency cannulation of internal jugular vein under real time ultrasonographic guidance with platelet count less than 50,000/cu mm and/or international normalized ratio (INR) more than 1.5 were enrolled. Major and minor complications during the procedure were noted.Results: Internal jugular vein was successfully cannulated in all the patients. The mean INR of patients having minor complications (provided that platelet count > 50000) was found to be 3.07 with 95% confidence interval(CI) being 2.37-3.77. The mean platelet count of patients having minor complications (provided that the INR<1.5) was found to be 27428 with 95% CI being 19428-36000. There was a significant relationship between margin of safety and occurrence of minor complications (>7mm vs 7mm or less; p value 0.027). Number of attempts while performing internal jugular vein cannulation was associated with minor complications (mean 1.5 with CI 1.2-1.78 vs mean 1.08 with 95% CI 1.00-1.25; p value 0.023). No major complications were reported during the study regardless of platelet count, INR, margin of safety or number of attempts.Conclusions: Emergency cannulation of internal jugular vein may be safely performed in coagulopathic adult patients under real-time ultrasound guidance when performed by an experienced physician.Bangladesh Crit Care J September 2017; 5(2): 93-96

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 Ultrasound-guided anatomical evaluation and percutaneous cannulation of the right internal jugular vein in infants <4000 g

2019 ◽  
Vol 21 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Filiz Uzumcugil ◽  
Aysun Ankay Yilbas ◽  
Basak Akca
Keyword(s):  
Carotid Artery ◽  
Real Time ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Anatomical Variation ◽  
Complication Rates ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Vein Access ◽  
The Right

Background: The commonly preferred right internal jugular vein was investigated in terms of its dimensions, the relationship between its dimensions and anthropometric measures, and the outcomes of its cannulation in infants. Data regarding its position with respect to the carotid artery indicated anatomical variation. Aim: The aim of this study was to share our observations pertaining to the anatomy and position of the right internal jugular vein with respect to carotid artery using ultrasound and our experience with ultrasound-guided right internal jugular vein access in neonates and small infants. Materials and methods: A total of 25 neonates and small infants (<4000 g) undergoing ultrasound-guided central venous cannulation via right internal jugular vein within a 6-month period were included. Ultrasound-guided anatomical evaluation of the vein was used to obtain the transverse and anteroposterior diameters, the depth from skin and the position with respect to the carotid artery. Real-time ultrasound-guided central cannulation success rates and complication rates were also obtained. The patients were divided into two groups with respect to their weight in order to compare both the position and the dimensions of right internal jugular vein and cannulation performance in infants weighing <2500 g and ⩾2500 g. Results: The position was lateral to the carotid artery in 84% of all infants and similar in both groups. The first-attempt success rates of cannulation were similar (70% vs 73.3%) in both groups, with an overall success rate of 88%. Conclusion: Right internal jugular vein revealed a varying position with respect to carotid artery with a higher rate of lateral position. The presence of such anatomical variation requires ultrasonographic evaluation prior to interventions and real-time guidance during interventions involving right internal jugular vein.

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 Trial of Ultrasound Image–based Skin Surface Marking versus  Real-time Ultrasound-guided Internal Jugular Vein Catheterization in Infants

2007 ◽  
Vol 107 (5) ◽  
pp. 720-724 ◽  
Author(s):  
Koji Hosokawa ◽  
Nobuaki Shime ◽  
Yuko Kato ◽  
Satoru Hashimoto
Keyword(s):  
Real Time ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Ultrasound Image ◽  
Group Versus ◽  
Ultrasound Guided ◽  
Ultrasound Technique ◽  
The Real ◽  
Venous Catheterization ◽  
Neonates And Infants

Background Ultrasound-guided central venous catheterization has been recommended to increase the procedural success rate and enhance patient safety. However, few studies have examined the potential advantages of one ultrasound technique with another, specifically in small infants. Methods The authors randomly assigned 60 neonates and infants weighing less than 7.5 kg to an ultrasound-guided skin-marking method (n = 27) versus real-time ultrasound-assisted internal jugular venous catheterization (n = 33). The times to successful puncture of the internal jugular vein and to catheterization were measured. Attempts at needle punctures for successful catheterization were counted. Procedural complications were recorded. Results In the real-time group, compared with the skin- marking group, venous puncture was completed faster (P = 0.03), the time required to catheterize was shorter (P &lt; 0.01), and fewer needle passes were needed. Specifically, fewer than three attempts at puncture were made in 100% of patients in the real-time group, versus 74% of patients in the skin-marking group (P &lt; 0.01). A hematoma and an arterial puncture occurred in one patient each in the skin-marking group. Conclusions The real-time ultrasound guidance method could enhance procedural efficacy and safety of internal jugular catheterization in neonates and infants.

Real-time ultrasound guided placement of temporary internal jugular vein catheters: Assessment of technical success and complication rates in nephrology practice

Nephrology ◽  
2012 ◽  
Vol 17 (7) ◽  
pp. 603-606 ◽  
Author(s):  
HADIM AKOGLU ◽  
SERHAN PISKINPASA ◽  
EZGI C YENIGUN ◽  
RAMAZAN OZTURK ◽  
FATIH DEDE ◽  
...  
Keyword(s):  
Real Time ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Complication Rates ◽  
Technical Success ◽  
Ultrasound Guided
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