American Journal of Roentgenology, Vol 169, 731-733, Copyright © 1997 by American Roentgen Ray Society

ARTICLES

A sonographically guided technique for central venous access

UK Teichgraber, T Benter, M Gebel and MP Manns
Department of Gastroenterology and Hepatology, Hannover Medical School, Germany.

OBJECTIVE: The internal jugular vein (IJV) is an important access to the central venous system. We compared sonographically guided technique with the traditional anatomic landmark technique for IJV catheterization. SUBJECTS AND METHODS: In a prospective randomized trial, 100 patients underwent routine catheterization of the IJV (50 patients in the sonography group and 50 patients in the anatomic landmark group). Access time, failure rates, and complication rates were evaluated. In addition, the physicians' number of years of experience with catheter insertion was recorded. RESULTS: Access time was markedly shorter with the sonographically guided technique (mean, 15.2 sec; range, 8-76 sec) than with the anatomic landmark technique (mean, 51.4 sec; range, 3-820 sec) (p = .001). The failure rate was significantly lower with the sonographically guided technique (p = .002). Complications were fewer with the sonographically guided technique (neck hematoma, 2% versus 10%; plexus irritation, 4% versus 6%; carotid artery puncture, 0% versus 12%). We found that the number of years of postgraduate clinical training was greater in the group of physicians using the anatomic landmark technique. CONCLUSION: The sonographically guided technique is associated with less risk and less inconvenience for patients, especially critically ill patients, for whom the technique provides fast, safe, and easy IJV catheterization.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				D. Feller-Kopman Ultrasound-Guided Internal Jugular Access: A Proposed Standardized Approach and Implications for Training and Practice Chest, July 1, 2007; 132(1): 302 - 309. [Abstract] [Full Text] [PDF]

				F. F. Mussa, S. Towfigh, V. L. Rowe, K. Major, D. B. Hood, and F. A. Weaver Current Trends in the Management of Iatrogenic Cervical Carotid Artery Injuries Vascular and Endovascular Surgery, October 1, 2006; 40(5): 354 - 361. [Abstract] [PDF]

				R. Bhat, A. Severn, and S. Chakraverty Shortening peel-away sheaths prior to dialysis line insertion--potential decrease of patient risk Nephrol. Dial. Transplant., September 1, 2006; 21(9): 2642 - 2643. [Full Text] [PDF]

				L. A. Eisen, M. Narasimhan, J. S. Berger, P. H. Mayo, M. J. Rosen, and R. F. Schneider Mechanical complications of central venous catheters. J Intensive Care Med, January 1, 2006; 21(1): 40 - 46. [Abstract] [PDF]

				M. J. Sands Vascular Access in the Adult Home Infusion Patient JPEN J Parenter Enteral Nutr, January 1, 2006; 30(1_suppl): S57 - S64. [Abstract] [Full Text] [PDF]

				P Atkinson, A Boyle, S Robinson, and G Campbell-Hewson Should ultrasound guidance be used for central venous catheterisation in the emergency department? Emerg. Med. J., March 1, 2005; 22(3): 158 - 164. [Abstract] [Full Text] [PDF]

				G. Parry Trendelenburg position, head elevation and a midline position optimize right internal jugular vein diameter: [La position de Trendelenburg, l'elevation de la tete et une position mediane augmentent le diametre de la veine jugulaire interne droite] Can J Anesth, April 1, 2004; 51(4): 379 - 381. [Abstract] [Full Text] [PDF]

				D. C. McGee and M. K. Gould Preventing Complications of Central Venous Catheterization N. Engl. J. Med., March 20, 2003; 348(12): 1123 - 1133. [Full Text] [PDF]

				G. Abbott and P. Evans Therapeutic embolization of an internal mammary artery damaged by placement of a central venous catheter Br. J. Anaesth., January 1, 2001; 86(1): 143 - 145. [Abstract] [Full Text] [PDF]

				W. R. Fry, G. C. Clagett, and P. T. O'Rourke Ultrasound-Guided Central Venous Access Arch Surg, July 1, 1999; 134(7): 738 - 741. [Abstract] [Full Text] [PDF]