Related Experiment Video

Updated: May 31, 2026

Catheterization of the Carotid Artery and Jugular Vein to Perform Hemodynamic Measures, Infusions and Blood Sampling in a Conscious Rat Model
09:05

Catheterization of the Carotid Artery and Jugular Vein to Perform Hemodynamic Measures, Infusions and Blood Sampling in a Conscious Rat Model

Published on: January 30, 2015

A comparison between blood flow outcomes of tunneled external jugular and internal jugular hemodialysis catheters

Hemender S Vats1, Janet Bellingham, Jason W Pinchot

  • 1Section of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 52713, USA. hvats@uwhealth.org

The Journal of Vascular Access
|July 5, 2011
PubMed

Insights

The external jugular (EJ) vein offers comparable blood flow outcomes to the right and left internal jugular (IJ) veins for hemodialysis (HD) catheters. This study suggests EJ vein placement is a viable option for long-term venous access.

Area of Science:

  • Nephrology
  • Vascular Access
  • Medical Devices

Background:

  • The right internal jugular (RIJ) vein is typically preferred for long-term hemodialysis (HD) central venous catheters (CVC).
  • Left internal jugular (LIJ) vein use may compromise future arteriovenous fistula/graft (AVF/AVG) placement due to central venous stenosis.
  • The right external jugular (EJ) vein presents a potential alternative access site.

Purpose of the Study:

  • To compare the blood flow outcomes of percutaneously placed EJ, LIJ, and RIJ HD catheters.
  • To evaluate the efficacy of EJ vein catheterization as a long-term HD access modality.

Main Methods:

  • A prospectively collected database of 46 hemodialysis patients receiving tunneled catheters over 4 years was analyzed.
  • Blood flow outcomes of date-matched RIJ, LIJ, and EJ catheters were compared at 30 and 90 days.
  • Analysis of Covariance (ANOVA) and multiple regression were used to assess outcomes and influencing factors.

Main Results:

  • No significant difference in 90-day blood flow outcomes was observed among the RIJ, LIJ, and EJ catheter groups.
  • Thirty-day blood flow measurements were comparable across the three groups (RIJ: 348.5±56.62, LIJ: 341±22.42, EJ: 365.7±71.76 mL/min).
  • No patient covariates (age, sex, race, diabetes) were associated with 30- or 90-day blood flow outcomes.

Conclusions:

  • External jugular vein (EJ) catheter blood flow outcomes at 30 and 90 days are comparable to historical data for LIJ and RIJ catheters.
  • EJ CVC placement demonstrates potential as an alternative long-term hemodialysis access.
  • Further prospective studies are warranted to establish the role of EJ CVC placement.
Abstract

More Related Videos

A Murine Model of Hemodialysis Access-Related Hand Dysfunction08:39

A Murine Model of Hemodialysis Access-Related Hand Dysfunction

Published on: May 31, 2022

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge09:32

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge

Published on: January 20, 2023

Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...