Percutaneous catheterization of the jugular bulb with a Doppler probe: technical note

On-line measurement of jugular venous bulb oxygen saturation may be of clinical value in patients with head injuries. Cannulation of the jugular bulb may be technically difficult in this group of patients. Trendelenberg positioning and head rotation may be associated with increased morbidity or mortality. A technique is described whereby catheterization can be performed with the head of the bed elevated and the neck in a neutral position. A needle with a Doppler probe is used to distinguish between the carotid artery and the internal jugular vein. The needle and the probe are then directed to the audible signal representative of the jugular vein. Once the vein is penetrated, placement of a fiberoptic oxygen saturation catheter is performed in the usual fashion. This technique allows auditory feedback to guide the course of the needle and decreases the morbidity that may be associated with the "blind" technique.