Cannulation of Internal Jugular Vein
Conditions
Keywords
Internal Jugular Vein, Catheterization, Central Venous, Ultrasonography, Ultrasound-Guided Procedures, Central Venous Catheters
Brief summary
To compare the frequency of first pass success by short axis versus long axis for cannulation of internal jugular vein.
Detailed description
This randomized controlled trial aims to compare the effectiveness of short-axis and long-axis ultrasound-guided approaches for cannulation of the internal jugular vein (IJV) in terms of first-pass success. Central venous catheterization is a commonly performed procedure for invasive monitoring and administration of medications and fluids. Ultrasound guidance has improved the safety and success of IJV cannulation compared with traditional landmark-based techniques; however, uncertainty remains regarding the optimal ultrasound imaging approach. A total of 60 eligible patients undergoing IJV cannulation will be enrolled and randomly allocated into two equal groups. Participants in Group A will undergo ultrasound-guided IJV cannulation using the short-axis approach, while participants in Group B will undergo cannulation using the long-axis approach. All procedures will be performed by the researcher under direct supervision using standardized ultrasound-guided techniques. The primary objective is to compare the frequency of first-pass success between the two approaches. First-pass success is defined as successful IJV cannulation with a single skin puncture and without needle redirection. Baseline demographic and clinical characteristics will be recorded before the procedure. The findings of this study may help identify the preferred ultrasound-guided technique for maximizing first-pass success during IJV cannulation and potentially reducing procedure-related complications associated with multiple cannulation attempts.
Interventions
DEVICEShort-Axis Ultrasound-Guided Internal Jugular Vein Cannulation
Internal jugular vein cannulation performed under ultrasound guidance using the short-axis approach. The transducer is placed in a transverse orientation at the level of the cricoid cartilage, allowing visualization of the internal jugular vein and carotid artery during needle insertion.
DEVICELong-Axis Ultrasound-Guided Internal Jugular Vein Cannulation
Internal jugular vein cannulation performed under ultrasound guidance using the long-axis approach. The transducer is rotated to obtain a longitudinal view of the internal jugular vein, allowing continuous visualization of the needle during vessel cannulation.
Sponsors
University of Health Sciences Lahore
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
25 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Age 25-70 years. * Either male or female gender. * Undergoing cannulation of IJV.
Exclusion criteria
* Patients who will be on hemodialysis therapy through double lumen catheter in IJV, assessed by reviewing previous medical records. * Patients who will have history of previous insertion of IJV line, assessed by reviewing previous medical records. * Patients with history of neck surgery, assessed by reviewing previous medical records. * Uncooperative patient. * Platelet count \< 50,000/mm3. * International normalized ration 3 times upper normal limit (1.1).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| First-Pass Success Rate of Ultrasound-Guided Internal Jugular Vein Cannulation | Assessed during the cannulation procedure (within 5 minutes of initiation of cannulation). | First-pass success rate of ultrasound-guided internal jugular vein cannulation, defined as successful venous cannulation with a single skin puncture and needle pass. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total Cannulation Success Rate | Assessed during the procedure (within 15 minutes). | Total cannulation success rate, defined as successful placement of the internal jugular venous catheter. |
| Number of Needle Passes Required for Successful Cannulation | Recorded during the procedure. | Total number of needle insertion attempts required to achieve successful ultrasound-guided internal jugular vein cannulation. |
| Incidence of Hematoma Formation at the Cannulation Site | Assessed immediately after the procedure and within 24 hours. | Occurrence of hematoma at the internal jugular vein cannulation site following ultrasound-guided catheter insertion. |
| Incidence of Posterior Vessel Wall Puncture | Assessed during the procedure. | Occurrence of unintended puncture of the posterior wall of the internal jugular vein during ultrasound-guided cannulation. |
| Incidence of Pneumothorax Following Cannulation | Assessed within 24 hours following cannulation. | Occurrence of pneumothorax associated with ultrasound-guided internal jugular vein cannulation. |
| Overall Procedure-Related Complications | Assessed during the procedure and up to 24 hours after cannulation. | Frequency of procedure-related adverse events, including hematoma, posterior vessel wall puncture, pneumothorax, or other complications occurring during or after ultrasound-guided internal jugular vein cannulation. |
Countries
Pakistan
Contacts
CONTACTWaleed Noor, MBBS FCPS
CONTACTShahida Khawaja, MBBS FCPS
STUDY_CHAIRShahida Khawaja, MBBS, FCPS
National Hospital and Medical Center
Outcome results
None listed