Internal jugular access using pocket ultrasound in a simulated model: comparison between biplane and monoplane...

No consensus exists regarding the superior ultrasound visualization technique for central venous access. Prior research has shown that both in-plane and out-of-plane methods are widely utilized in clinical settings. That uncertainty drove the investigation into whether newer biplane imaging offers distinct benefits. It was already known that ultrasound improves safety and efficiency during vascular procedures. This gap motivated a direct comparison of these three specific imaging modalities. No prior work had resolved whether biplane views provide measurable advantages over traditional approaches. The current literature remains divided on which method optimizes procedural outcomes. This study addresses the need for empirical data in a controlled simulation environment.

The aim of this study was to compare the success and time required for biplane visualization versus in-plane and out-of-plane techniques. Researchers sought to determine if biplane imaging offers measurable advantages for central venous access. This investigation addressed the lack of clear evidence regarding the superiority of one ultrasound method over others. The team focused on internal jugular cannulation using a simulated model to maintain consistency. They hypothesized that evaluating these techniques would clarify their relative efficiency in a controlled setting. The motivation stemmed from the widespread use of ultrasound in emergency medicine. By standardizing the procedure, the authors intended to provide objective data for clinical practice. This work specifically targets the performance metrics of different visualization strategies.

Review approach involved ten emergency medicine specialists performing sixty simulated cannulation events. The design randomized the visualization technique for each procedure to ensure unbiased comparisons. Each participant attempted intravenous access on a model with a three-attempt limit. Investigators tracked the number of attempts required for successful vessel entry. They documented the success of both puncture and venous cannulation. The team measured the time needed to obtain an optimal imaging window. They also recorded the duration for needle visualization and guidewire passage. This systematic approach allowed for a direct evaluation of biplane, in-plane, and out-of-plane techniques.

Key findings from the literature indicate that all three visualization techniques achieved a 100% cannulation success rate. First-attempt success reached 95% for biplane imaging and 100% for both in-plane and out-of-plane methods. The median total procedure time was 29.9 seconds for biplane, 25.2 seconds for in-plane, and 29 seconds for out-of-plane. Statistical analysis revealed no significant differences in these timing metrics, with a p-value of 0.999. No meaningful variations occurred regarding needle redirection frequency across the tested groups. Posterior wall puncture rates remained similar among all three imaging approaches. These results demonstrate that biplane visualization performs comparably to established techniques in this model. The data suggest that no single method provides a clear advantage in this simulated setting.

The authors suggest that biplane visualization does not offer a significant advantage over traditional methods for internal jugular cannulation. Synthesis and implications indicate that all three techniques achieve high success rates in simulated models. The researchers propose that clinicians may select any of these approaches without compromising procedural safety. No evidence emerged to support the superiority of biplane imaging regarding time or accuracy. The study highlights that procedural efficiency remains comparable across these three distinct visualization strategies. These findings imply that equipment choice might depend on individual preference rather than clinical necessity. The authors note that larger investigations are required to validate these observations in diverse settings. Future work should focus on confirming these results within broader clinical contexts.