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The Internal jugular veins are asymmetric. Usefulness of ultrasound before catheterization
D Lichtenstein1, R Saïfi, R Augarde
1Service de Réanimation Médicale, H pital Ambroise-Paré, Boulogne, France.
Objective:
To demonstrate an asymmetry of the internal jugular veins, a finding which will have consequences for catheterization.
Design:
Prospective study.
Setting:
The medical ICU of a university-affiliated teaching hospital.
Patients:
Eighty critically ill consecutive patients.
Intervention:
Measurement of the cross-sectional area of the internal jugular veins. Search for an asymmetry, defined as an area at least twice that of the contralateral vein.
Results:
An asymmetry was noted in 62.5% of the patients. The dominant vein was the right in only 68 % of these cases. In addition, 23% of the 160 jugular internal veins had an area of 0.4 cm2 or less.
Conclusions:
Using a simple technique, ultrasound identifies the dominant internal jugular vein, thus indicating the safer side before blind catheterization.