Ultrasound Guided Internal Jugular Vein Cannulation in Critically ILL Patients in Icu

Portable ultrasound machines are highly valuable in ICUs, where a patient's condition might not permit shifting the patient to the USG department for imaging and proper positioning may be difficult due to haemodynamic condition of patient. Traditionally central lines are put blindly using anatomical landmarks, which often result in complications such as difficulty in access, misplaced lines, pneumothorax, bleeding from inadvertent arterial punctures, etc. Ultrasonography provides “real time” imaging, i.e., the needle can be visualized entering the vein that may result in less associated complication.

We performed a study regarded

ease of cannulation

time consumed

associated complications

in USG guided IJV cannulation in ICU patients.

The study was performed in a ICU. Twenty five patients were selected for IJV insertion. The right internal jugular vein (IJV) was cannulated in all. A portable ultrasound machine was used during cannulation. The vessels were visualized in the transverse section with the internal carotid artery (ICA) identified as a circular pulsatile structure, while the IJV as a lateral, oval nonpulsatile structure). The needle was inserted perpendicular to the skin under visualization on the US screen. Central venous line was then inserted by the Seldinger technique.. in this we study parameters like time for insertion, attempts required, and complications encountered.

The mean time to successful insertion was 126.2plusmn;15.4 sec in USG guided technique. Out of 25 patients, all (100%) cannulated successfully. Only in 1 patient carotid artery was punctured and was cannulated in 2nd attempt. success rate is 100%. 96% patients are cannulated in first attempt.

USG-guided CVC is thus easier, quicker, and safer than landmark approach.