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[Cannulation of the internal jugular vein using 2 ultrasonic technics. A comparative controlled study]
A Scherhag1, A Klein, J P Jantzen
1Klinik für Anaesthesiologie der Johannes Gutenberg-Universität, Mainz.
Der Anaesthesist
|November 1, 1989
Summary
Ultrasound guidance improves internal jugular vein (IJV) and carotid artery (CA) identification compared to anatomical landmarks alone. Real-time ultrasonography offers superior visualization of the IJV
Area of Science:
- Vascular Access
- Medical Ultrasound
- Anatomy
Background:
- Internal jugular vein (IJV) access is crucial for central venous catheterization.
- Traditional anatomical landmark (AL) methods for IJV localization have limitations.
- Ultrasound offers potential for improved IJV and carotid artery (CA) identification.
Purpose of the Study:
- To compare AL-guided IJV cannulation with ultrasound-guided methods.
- To evaluate ultrasound Doppler and real-time ultrasonography for IJV and CA localization.
- To assess the impact of different localization methods on puncture success and complications.
Main Methods:
- Three groups: Group I (AL), Group II (ultrasound Doppler), Group III (real-time ultrasonography).
- Central venous catheters placed via Seldinger technique into the right IJV.
- Comparison of IJV/CA identification, puncture success, complications, and procedure time.
Main Results:
- Ultrasound methods located the IJV in all patients; ultrasonography identified its course.
- Typical IJV course identified in 80% (AL), 85% (Doppler), and 45% (ultrasonography).
- No significant differences in puncture number or complications; ultrasonography improved localization.
Conclusions:
- Real-time ultrasonography enhances IJV and CA localization, especially for atypical courses.
- Ultrasound guidance can improve success rates, particularly when initial attempts fail.
- While localization time increases with ultrasound sophistication, overall catheter placement time is not prolonged.