title: Effects of clinical maneuvers on sonographically determined internal jugular vein size during venous cannulation.
abstract: We sought to define variations in internal jugular vein (IJV) anatomy and the effect of recommended cannulation maneuvers on a population of ICU patients. Maneuvers that decreased IJV lumen cross-sectional area were carotid artery palpation (1.48 to 0.82 cm2, p less than .05) and advancement of the needle (1.57 to 0.75 cm2, p less than .001). The head-down (modified Trendelenburg) position increased IJV lumen cross-sectional area (1.18 to 1.62 cm2, p less than .05). There was wide variability in IJV anatomic features, although most patients had patent veins.
authors.affiliation: Department of Critical Care Medicine, National Institutes of Health, Bethesda MD.
authors.forename: D L
authors.initials: DL
authors.lastname: Mallory
authors.forename: T
authors.initials: T
authors.lastname: Shawker
authors.forename: R G
authors.initials: RG
authors.lastname: Evans
authors.forename: W T
authors.initials: WT
authors.lastname: McGee
authors.forename: M
authors.initials: M
authors.lastname: Brenner
authors.forename: M
authors.initials: M
authors.lastname: Parker
authors.forename: G
authors.initials: G
authors.lastname: Morrison
authors.forename: P
authors.initials: P
authors.lastname: Mohler
authors.forename: C
authors.initials: C
authors.lastname: Veremakis
authors.forename: J E
authors.initials: JE
authors.lastname: Parrillo
mesh_terms: D002339:Carotid Arteries; D002406:Catheterization, Peripheral; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007601:Jugular Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D010173:Palpation; D014463:Ultrasonography