Ultrasound-facilitated central venous cannulation.
OBJECTIVE
To compare the conventional method for cannulation of the internal jugular vein with the ultrasound-aided technique.


METHODS
Prospective, randomized trial.


METHODS
Medical and surgical patients requiring central cannulation in a university hospital.


METHODS
Consecutive medical and surgical patients in whom central venous cannulation was indicated.


METHODS
Cannulation of the internal jugular vein was performed by one anesthesiologist. During the first 6 months, the ultrasound-aided technique (n = 29) was used, and during the second 6 months, the conventional technique (n = 27) was applied.


RESULTS
The venous lumen was reached with fewer punctures (1.2 +/- 0.5 vs. 3.3 +/- 3.0 punctures per patient) and the cannulation time was shorter (35 +/- 19 vs. 198 +/- 211 secs) while using the ultrasound-aided technique. The ultrasound-aided method showed that the large-bore (diameter greater than 2.0 mm) needles invariably perforated the medial wall of the internal jugular vein, increasing the risk of perforating the adjacent carotid artery.


CONCLUSIONS
Ultrasound guidance reduces both the duration of time and the number of punctures required to cannulate the internal jugular vein. The Seldinger technique appears safer for catheterization of the internal jugular vein.
Koski
E M
EM
Department of Anaesthesiology, Kuopio University Hospital, Finland.
Suhonen
M
M
Mattila
M A
MA
D002405:Catheterization, Central Venous / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011897:Random Allocation; D014463:Ultrasonography