Skin-traction method prevents the collapse of the internal jugular vein caused by an ultrasound probe in real-time ultrasound-assisted guidance.
OBJECTIVE
Real-time ultrasound-assisted guidance for catheterization of the internal jugular vein (IJV) is known to be useful, especially for a small-sized vein, which is difficult to catheterize. However, one of the problems with real-time ultrasound-assisted guidance is that the ultrasound probe itself can collapse the vein. We have developed a novel "skintraction method (STM)", in which the puncture point of the skin over the IJV is stretched upwards with several pieces of surgical tape in the cephalad and caudal directions with the aim being to facilitate catheterization of the IJV. We examined whether this method increased the compressive force required to collapse the IJV.


METHODS
In ten volunteers, the compressive force required to collapse the right IJV, and the cross-sectional area and anteroposterior and transverse diameters of the IJV were measured with ultrasound imaging in the supine position (SP) with or without the STM or in the Trendelenburg position of 10 degrees head-down (TP) without the STM.


RESULTS
The compressive force to required to collapse the vein was increased significantly with the STM, while the crosssectional area and anteroposterior diameter of the vein in the SP with STM were similar to those in the TP without the STM.


CONCLUSIONS
With the STM, not only the cross-sectional area but also the compressive force required to collapse the IJV increased. Thus, the STM may facilitate real-time ultrasoundassisted guidance for catheterization of the IJV by maintaining the cross-sectional area of the vein during the guidance.
Sasano
Hiroshi
H
Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8622, Japan.
Morita
Masato
M
Azami
Takafumi
T
Ito
Shoji
S
Sasano
Nobuko
N
Kato
Rina
R
Hirate
Hiroyuki
H
Ito
Hiroaki
H
Takeuchi
Akinori
A
Sobue
Kazuya
K
D000328:Adult; D002406:Catheterization, Peripheral / Q000379:methods*; D005260:Female; D018475:Head-Down Tilt; D006801:Humans; D007601:Jugular Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012879:Skin Physiological Phenomena; D016683:Supine Position; D014465:Ultrasonics / Q000009:adverse effects*; D014463:Ultrasonography