OBJECTIVE: To describe current cannulation of the internal jugular vein (CIJV) practice in a university anesthesia department. DESIGN: Prospective, observational, and not randomized. SETTING: Operating rooms of the Hospital of the University of Pennsylvania. PARTICIPANTS: Elective surgical patients requiring CIJV (n = 426). INTERVENTIONS: CIJV performed by real-time ultrasound visualization (U-CIJV) or by anatomic landmarks (AL-CIJV). MEASUREMENTS AND MAIN RESULTS: A total of 462 procedures were studied in 426 patients. Overall cannulation failure was 2.1% with U-CIJV and 13.8% with AL-CIJV (p = 0.0001). Cumulative CIJV success by the sixth needle pass was 94.0%, regardless of technique. Junior operators performed 75.3% of CIJV, of which 86.8% was U-CIJV. First-pass success across operators was 60% to 70% for U-CIJV and 50% to 80% for AL-CIJV. Arterial puncture rates averaged 7.0%, regardless of technique (p = 0.45). The junior operator may be more at risk for arterial puncture during U-CIJV. CONCLUSION: U-CIJV offers incomplete protection against arterial injury in this practice compared with the literature. A possible solution is the ultrasound needle guide, which may minimize arterial injury, especially with junior operators. Copyright 2002, Elsevier Science (USA). All rights reserved.
OBJECTIVE: To describe current cannulation of the internal jugular vein (CIJV) practice in a university anesthesia department. DESIGN: Prospective, observational, and not randomized. SETTING: Operating rooms of the Hospital of the University of Pennsylvania. PARTICIPANTS: Elective surgical patients requiring CIJV (n = 426). INTERVENTIONS:CIJV performed by real-time ultrasound visualization (U-CIJV) or by anatomic landmarks (AL-CIJV). MEASUREMENTS AND MAIN RESULTS: A total of 462 procedures were studied in 426 patients. Overall cannulation failure was 2.1% with U-CIJV and 13.8% with AL-CIJV (p = 0.0001). Cumulative CIJV success by the sixth needle pass was 94.0%, regardless of technique. Junior operators performed 75.3% of CIJV, of which 86.8% was U-CIJV. First-pass success across operators was 60% to 70% for U-CIJV and 50% to 80% for AL-CIJV. Arterial puncture rates averaged 7.0%, regardless of technique (p = 0.45). The junior operator may be more at risk for arterial puncture during U-CIJV. CONCLUSION:U-CIJV offers incomplete protection against arterial injury in this practice compared with the literature. A possible solution is the ultrasound needle guide, which may minimize arterial injury, especially with junior operators. Copyright 2002, Elsevier Science (USA). All rights reserved.
Authors: M Lamperti; D Caldiroli; P Cortellazzi; D Vailati; A Pedicelli; F Tosi; M Piastra; D Pietrini Journal: Intensive Care Med Date: 2008-07-11 Impact factor: 17.440
Authors: Konstantinos Stefanidis; Nicos Pentilas; Stavros Dimopoulos; Serafim Nanas; Richard H Savel; Ariel L Shiloh; John Poularas; Michel Slama; Dimitrios Karakitsos Journal: Crit Care Res Pract Date: 2012-05-10
Authors: Dimitrios Karakitsos; Nicolaos Labropoulos; Eric De Groot; Alexandros P Patrianakos; Gregorios Kouraklis; John Poularas; George Samonis; Dimosthenis A Tsoutsos; Manousos M Konstadoulakis; Andreas Karabinis Journal: Crit Care Date: 2006 Impact factor: 9.097