Is a Neutral Head Position as Effective as Head Rotation During Landmark-Guided Internal Jugular Vein Cannulation? Results of a Randomized Controlled Clinical Trial
Yükleniyor...
Dosyalar
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
W B Saunders Co-elsevier Inc
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objective: Central venous access remains a cornerstone procedure for a variety of clinical conditions. Ultrasound studies suggest that rotation of the head increases the magnitude of the overlap of the internal jugular vein with the carotid artery. The authors assessed whether a neutral position of the head during anatomic landmark-guided cannulation of the internal jugular vein (UV) was an attractive alternative to rotating the neck to a >45 degrees head turn. Design: A prospective, randomized, controlled study. Setting: An education and research hospital and a university-affiliated hospital. Participants: Eighty patients requiring central venous catheterization in the right IJV. Interventions: Under general anesthesia, patients were positioned in the Trendelenburg position with extension of the neck. In the rotated group, the head was rotated to the left at >45 degrees. In the neutral group, the head was placed in the neutral position. Right IJV cannulation was performed using the central approach with the needle angled toward the ipsilateral nipple. The primary outcome variable was the cumulative success rate, which was defined as IJV puncture achieved in the first 3 attempts using a finder needle. A p value of <0.05 was considered statistically significant. Measurements and Main Results: Groups were similar in terms of demographic data. The success rates of finder needle passes into the IJV on the first attempt were 87.5% and 37.5% (p < 0.05), and the cumulative success rates on the first 3 attempts were 97.5% and 57.5% in the rotated and neutral groups, respectively (p < 0.05). Carotid artery puncture only occurred in 2 patients in the rotated group. Conclusions: Because of the lower success rate, the neutral head position is not an attractive alternative for IJV catheterization when compared with the rotated head position in a central landmark IJV approach.
Açıklama
Anahtar Kelimeler
Central venous access, common carotid artery, head position, internal jugular vein, complications
Kaynak
Journal of Cardiothoracic and Vascular Anesthesia
WoS Q Değeri
Q3
Scopus Q Değeri
Q2
Cilt
26
Sayı
6
Künye
Apiliogullari, B., Kara, I., Apiliogullari, S., Arun, O., Saltali, A., Celik, J. B., (2012). Is a Neutral Head Position as Effective as Head Rotation During Landmark-Guided Internal Jugular Vein Cannulation? Results of a Randomized Controlled Clinical Trial. Journal of Cardiothoracic and Vascular Anesthesia, 26(6), 985-988. Doi:10.1053/j.jvca.2012.07.005
