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Comparison of Three Different Approaches to Ultrasound-guided Internal Jugular Vein Cannulation: A Randomised Clinical Study
Correspondence Address :
Shilpa Jagadeesh,
Assistant Professor, Department of Anesthesiology, St. John’s Medical College Hospital, Koramangala, Sarjapura Road, Bengaluru-560034, Karnataka, India.
E-mail: shilpa.j.rao@gmail.com
Introduction: The standard approaches to ultrasound-guided central line insertion by Short Axis (SAX) and Long Axis (LAX) have limitations. The Medial Oblique Axis (M-OAX) approach allows visualisation of the length of the needle in real-time along with both the artery and vein.
Aim: To compare the three approaches for ultrasound-guided right Internal Jugular Vein (IJV) cannulation with respect to ease of access and complications.
Materials and Methods: A total of 171 patients scheduled to undergo right IJV cannulation were divided equally into three groups-SAX (Group-1), LAX (Group-2), and M-OAX (Group-3). They were compared with respect to first pass success, Venous Access Time (VAT), guide wire insertion time, catheterisation time, and complications. Continuous variables were compared with Analysis of Variance (ANOVA) test. Categorical variables were analysed using the Chi-square test. The p-value <0.05 was considered significant.
Results: First pass success was 55 (96.49%), 53(92.98%), and 54 (94.74%) in groups 1, 2, and 3, respectively. The VAT, guidewire insertion time, and catheterisation time were significantly lesser in Groups 1 and 3 compared to 2 (p<0.001). Two cases of carotid artery puncture were noted in Group-2, though statistically not significant (p>0.05).
Conclusion: The medial oblique approach to IJV cannulation combines the advantages of both LAX and SAX and is a safer alternative with easier and faster venous access.
Carotid artery, Central venous catheterisation, Ultrasonography
DOI: 10.7860/JCDR/2024/69660.19532
Date of Submission: Jan 17, 2024
Date of Peer Review: Feb 26, 2024
Date of Acceptance: Apr 11, 2024
Date of Publishing: Jun 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. No
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ETYMOLOGY: Author Origin
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