The success rate and safety of internal jugular vein cannulation using anatomical landmark technique in patients undergoing cardiothoracic surgery

OBJECTIVE: The aim of this study is to find out if an ultrasound technique has advantages over the conventional landmark technique. METHODS: This is a prospective randomized comparative study on 120 patients requiring central venous cannulation of the right internal jugular vein. The study comprised of two groups: ultrasound and landmark groups, each consisting of 60 patients. The outcome measures were compared between the groups. RESULTS: Cannulation of the internal jugular vein was successful in 58 patients in the ultrasound group and in 53 in the landmark group. The number of attempts was 1.5 (1 - 3) and 2 (1 - 3) in the ultrasound and landmark group respectively (p = 0.001). The time taken for the successful cannulation was 4.9 +/- 1.7 minutes in the ultrasound approach and 8.0 +/- 2.8 minutes in the landmark approach (p = 0.00). The internal jugular vein diameter in the supine position was 11.2 +/- 1.5 mm which increased to 15.04 +/- 1.5 mm with a 15 degrees head-down position in the USG group (p = 0.001). The first attempt success rate was 39/60 (63%) in the ultrasound group and 19/60 (32%) with the landmark technique. The seven (12%) failure cases in the landmark group were rescued by the ultrasound technique. Inadvertent carotid artery puncture occurred in 2/60 (3%) and 6/60 (10%) of patients in the ultrasound and land mark group respectively. CONCLUSIONS: Ultrasound improves success rate, minimizes cannulation time and complications during internal jugular vein cannulation. It can be employed as a rescue technique in cases of a failed landmark technique. Keywords:cannulation, central, landmark, technique, ultrasound.

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A comparison of internal jugular vein cannulation by ultrasound-guided and anatomical landmark technique in resource-limited emergency department setting

Journal of Medical Ultrasound ◽

10.4103/jmu.jmu_2_19 ◽

2019 ◽

Vol 27 (4) ◽

pp. 187 ◽

Cited By ~ 1

Author(s):

MeenhasOravil Kunhahamed ◽

SijuVarghese Abraham ◽

BabuUrumese Palatty ◽

SVimal Krishnan ◽

PunchalilChathappan Rajeev ◽

...

Keyword(s):

Emergency Department ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Anatomical Landmark ◽

Ultrasound Guided ◽

Internal Jugular Vein Cannulation ◽

Vein Cannulation ◽

Emergency Department Setting ◽

Resource Limited ◽

Landmark Technique

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Ultrasound guidance for internal jugular vein cannulation in PICU: a randomised controlled trial

Archives of Disease in Childhood ◽

10.1136/archdischild-2017-314568 ◽

2018 ◽

Vol 103 (10) ◽

pp. 952-956 ◽

Cited By ~ 3

Author(s):

Tiago Henrique de Souza ◽

Marcelo Barciela Brandão ◽

Thiago Martins Santos ◽

Ricardo Mendes Pereira ◽

Roberto José Negrão Nogueira

Keyword(s):

Success Rate ◽

Ultrasound Guidance ◽

Jugular Vein ◽

Controlled Trial ◽

Anatomical Landmark ◽

Control Group ◽

Internal Jugular Vein Cannulation ◽

The Us ◽

Randomised Controlled ◽

Landmark Technique

ObjectiveWe investigated whether ultrasound guidance was advantageous over the anatomical landmark technique when performed by inexperienced paediatricians.DesignRandomised controlled trial.SettingA paediatric intensive care unit of a teaching hospital.Patients80 children (aged 28 days to <14 years).InterventionsInternal jugular vein cannulation with ultrasound guidance in real time or the anatomical landmark technique.Main outcome measuresSuccess rate, success rate on the first attempt, success rate within three attempts, puncture time, number of attempts required for success and occurrence of complications.ResultsWe found a higher success rate in the ultrasound guidance than in the control group (95% vs 61%, respectively; p<0.001; relative risk (RR)=0.64, 95% CI (CI) 0.50 to 0.83). Success on the first attempt was seen in 95% and 34% of venous punctures in the US guidance and control groups, respectively (p<0.001; RR=0.35, 95% CI 0.23 to 0.54). Fewer than three attempts were required to achieve success in 95% of patients in the US guidance group but only 44% in the control group (p<0.001; RR=0.46, 95% CI 0.32 to 0.66). Haematomas, inadvertent arterial punctures, the number of attempts and the puncture time were all significantly lower in the ultrasound guidance than in the control group (p<0.015 for all).ConclusionsCritically ill children may benefit from the ultrasound guidance for internal jugular cannulation, even when the procedure is performed by operators with limited experience.Trial registration numberRBR-4t35tk.

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