title: [Internal jugular venous cannulation: what is the best approach?].
abstract: OBJECTIVE
  The aim of this study was to compare two approaches used for internal jugular venous cannulation: the anterior way, described by English et al. and the posterior way, described by Jernigan et al. The primary endpoint was the rate of success. The secondary endpoints were the related adverse events and the difficulty factors.
  
  
  METHODS
  Prospective, randomized open clinical trial.
  
  
  METHODS
  The study took place in the vital emergency room, the operating room and the emergency intensive care unit of Ibn Sina University hospital (Rabat, Morocco), between June and September 2010. Hundred and one patients needing a central venous catheter were randomized to undergo one of the two techniques. We compared: demographics, success rates, number of attempts, difficulty factors and adverse events.
  
  
  RESULTS
  The success rate was significantly higher in the posterior group (96% versus 68%, P < 0.001), with fewer attempts (1.3 ± 0.7 versus 2.1 ± 1.3; P < 0.001). There were less pneumothorax, (0 versus 6%) and more accidental arterial punctures (34 versus 25.5%) in the posterior group, but the difference wasn't significant. Finally, none of the difficulty factors were correlated to the failure rate.
  
  
  CONCLUSIONS
  This study shows that the posterior approach in internal jugular venous cannulation is more efficient than and as safe as the anterior approach.
authors.affiliation: Laboratoire de génétique et biométrie, faculté des Sciences, université Ibn Tofail, BP 133, Kénitra, Maroc. tlamkinsi@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Lamkinsi
authors.forename: A
authors.initials: A
authors.lastname: Kettani
authors.forename: Z
authors.initials: Z
authors.lastname: Belkhadir
authors.forename: J
authors.initials: J
authors.lastname: Tadili
authors.forename: M Y
authors.initials: MY
authors.lastname: Benjelloun
authors.forename: A
authors.initials: A
authors.lastname: Mosadik
authors.forename: S
authors.initials: S
authors.lastname: Ahid
authors.forename: M
authors.initials: M
authors.lastname: Faroudy
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007601:Jugular Veins / Q000033:anatomy & histology; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D017211:Treatment Failure