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Internal Jugular Vein Cannulation in Prone Position
1Intensive Care in Emergency Department, Mexican Institute of Social Security, Coahuila, Mexico.
Critical Care Explorations
|April 3, 2023
Summary
Prone decubitus positioning (PD) is a safe and feasible method for vascular access in acute respiratory distress syndrome (ARDS) patients. This technique is particularly beneficial for obese individuals, reducing risks associated with supine positioning.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Medical Procedures
Background:
- Prone decubitus (PD) positioning has been an adjuvant therapy for severe hypoxia in acute respiratory distress syndrome (ARDS) since 1970.
- Its use has surged in intensive care units (ICUs) during the COVID-19 pandemic.
- ARDS is defined by bilateral infiltrates, reduced respiratory compliance, small lung volumes, and severe hypoxemia.
Purpose of the Study:
- To evaluate the feasibility and safety of vascular access placement in patients with ARDS undergoing prone decubitus positioning.
- To identify patient subgroups who may benefit most from this procedure.
Main Methods:
- Vascular access placement in the prone decubitus position.
- Ultrasound guidance for vascular access procedures.
- Review of complication rates (pneumothorax, bleeding, arterial punctures).
Main Results:
- Vascular access in PD appears feasible and safe.
- Complication rates, including pneumothorax, bleeding, and arterial punctures, are minimal, especially with ultrasound guidance.
- Obese patients (BMI > 30 kg/m²) may benefit significantly.
Conclusions:
- Vascular access in the prone position is a safe and feasible procedure for ARDS patients.
- Ultrasound guidance minimizes complications.
- Obese patients are identified as a key group who may avoid risks associated with returning to the supine position.
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