Ultrasound-guided catheterization of the internal jugular vein in oncologic patients; comparison with the classical anatomic landmark technique: a prospective study.
OBJECTIVE
To compare the traditional anatomic landmark technique with the ultrasound-guided method for central venous catheterization.


METHODS
During three years, 551 patients underwent internal jugular vein catheterization; in 347 patients, the ultrasound-guided technique was used, while in the other 204 patients the catheter was introduced by using the classical anatomic landmark method. Operating time, complications (pneumothorax, puncture of carotid artery with or without hematoma formation), and number of attempts to achieve central venous catheterization were recorded.


RESULTS
The ultrasound-guided technique was associated with significantly shorter operating time (9.83+/-3.1 vs. 20+/-4.4 min, p<0.001) and less morbidity (pneumothorax, 0 vs. 2 patients [p<0.05], carotid artery puncture with or without hematoma formation, 1 vs. 16 patients [p<0.05]). Moreover, the ultrasound-guided technique was highly successful in achieving central venous catheterization (failure, 0 vs. 18 patients [p<0.05]), with significantly fewer attempts (1-3 attempts in 204 vs. 283 [p<0.01]), compared to the classical anatomic landmark technique.


CONCLUSIONS
The ultrasound-guided method is faster, more efficient, and less morbid procedure compared with the classical anatomic landmark technique. Therefore, it should be preferred over the classical landmark method, especially in high-risk patients for the development of complications.
Serafimidis
Konstantinos
K
4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, Athens, Greece.
Sakorafas
George H
GH
Konstantoudakis
George
G
Petropoulou
Konstantina
K
Giannopoulos
George P
GP
Danias
Nikolaos
N
Peros
George
G
Safioleas
Michael
M
D000970:Antineoplastic Agents / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007601:Jugular Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D008297:Male; D009369:Neoplasms / Q000188:drug therapy / Q000473:pathology; D011446:Prospective Studies; D018570:Risk Assessment; D017751:Safety Management; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
D000970:Antineoplastic Agents