Comparative evaluation between external jugular and internal jugular venous catheterization through landmark...

Area of Science:

• Medical Procedures
• Anesthesiology
• Vascular Access

Background:

• Central venous cannulation is essential for hemodynamic management when peripheral access is not feasible.
• The internal jugular vein is the preferred site, but alternatives are needed when it's inaccessible.
• The feasibility of external jugular vein cannulation as an alternative remains unclear.

Purpose of the Study:

• To compare the feasibility of external jugular vein cannulation versus internal jugular vein cannulation.
• To evaluate success rates, cannulation time, number of attempts, and complication incidence.
• To determine the efficacy of the external jugular vein as a secondary central venous access site.

Main Methods:

• A prospective, randomized, double-blinded study involving 100 patients.
• Central venous catheters were inserted via landmark technique into either the internal jugular vein (n=50) or external jugular vein (n=50).
• Data on cannulation attempts, time, and complications were meticulously recorded.

Main Results:

• Internal jugular vein cannulation had a success rate of 88% versus 78% for the external jugular vein (p=0.17).
• External jugular vein cannulation was significantly quicker (p=0.01).
• Complications were observed in 20% of internal jugular vein cases and 28% of external jugular vein cases, with more severe complications in the internal jugular vein group.

Conclusions:

• Anesthetists should consider alternative central venous cannulation routes.
• External jugular vein cannulation presents a feasible and efficient alternative.
• This technique offers a valuable option when the internal jugular vein is not accessible.