title: Central Venous Cannulation of the Internal Jugular Vein Using Ultrasound-Guided and Anatomical Landmark Techniques.
abstract: BACKGROUND
  Central venous cannulation is a current and important procedure used in the operating room and intensive care unit. Some studies have shown that the application of ultrasound-guided cannulation can improve the success rate of surgery, save time, reduce the number of required needlesticks, and mitigate many complications compared to anatomical landmark-guided cannulation.
  
  
  OBJECTIVE
  The aim of the present study was to draw a comparison between central venous cannulation of the internal jugular vein using ultrasound-guided and anatomical landmark-guided techniques.
  
  
  METHODS
  A total of 321 patients scheduled for cardiac surgery in the surgical ward of a general hospital were randomly treated with central venous cannulation using either anatomical landmarks (150 patients) or ultrasound guidance (170 patients). The demographic data of patients, the success rate of cannulation, the execution time, and the number of attempts for successful cannulation as well as the complications were recorded and subjected to statistical analysis.
  
  
  RESULTS
  The success rate of cannulation was 98.7% in the anatomical landmark-guided group and 99.4% in the ultrasound-guided group. The average operation times were 46.05 and 45.46 seconds in the anatomical landmark and ultrasound-guided groups, respectively. The two groups were not significantly different in terms of the success rates of treatment, the number of attempts, the time required for successful cannulation, or the prevalence of complications (P > 0.05) other than carotid artery puncture (P = 0.04).
  
  
  CONCLUSIONS
  In our conditions, the use of an anatomical landmark-guided procedure was the preferred treatment method due to limited resources and a lack of adequate training.
authors.affiliation: Cardiac Anesthesia Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Fathi
authors.affiliation: Research and Education Department, Razavi Hospital, Mashhad, Iran.
authors.forename: Azra
authors.initials: A
authors.lastname: Izanloo
authors.affiliation: Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Jahanbakhsh
authors.affiliation: Cardiac Anesthesia Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mehryar
authors.initials: M
authors.lastname: Taghavi Gilani
authors.affiliation: Cardiac Anesthesia Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Majidzadeh
authors.affiliation: Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Azam
authors.initials: A
authors.lastname: Sabri Benhangi
authors.affiliation: Cardiac Anesthetist, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Naser
authors.initials: N
authors.lastname: Paravi
keywords: Anatomic Landmark; Internal Jugular Vein; Ultrasound