Internal jugular vein catheterization: A comparison between ultrasound guided technique with landmark guided technique

Abstract

Introduction: Central venous cannulation is frequently performed
procedures to gain access to the central vein. With increased use of
ultrasonography to guide cannulation, the success rate has improved and
it has decreased the time required for cannulation and complications. The
aim of the study was to compare ultrasound guided technique (USG) and
landmark technique (LMG) in Internal jugular vein.

Materials and Methods: This study was conducted in National Medical
College and Teaching Hospital, Birgunj from July 2019 to July 2020. Ethical
clearance (NMC/420/075/076) was obtained from institutional review
committee of NMC Birgunj. Total of 60 patients were randomly allocated
into two groups; ultrasound group (USG) landmark group (LMG) underwent
landmark guided catheterization. Access time, number of attempts for
successful cannulation and incidence of various complications were
compared between groups. Data analysis was done with Statistical Package
for Social Science version 22.

Result: The study was conducted on 60 patients, divided randomly into
two groups with 30 patients in each group. The mean age for LMG was
48.57±16.08 years and for USG was 50.03±13.36 years. Out of 60 patients,
61.7% were male and 38.3% were female. The mean of neck dimension
for LMG and USG was 35.95±6.327 and 35.67±6.194 cm respectively. The
mean distance under LMG and USG was 19.07±1.780 and 18.33±2.368
cm respectively. The mean access time taken for LMG and USG was
403.10±98.111 and 217.57±75.408 seconds respectively (p<0.001). LMG
technique showed total 5 cases (16.7%) of carotid artery puncture during
procedure whereas there were no cases seen in USG (p value 0.05).

Conclusion: This study has shown better result of ultrasound guided internal
jugular cannulation when compared with landmark guided internal jugular
vein cannulation technique by decreasing number of needle passes, access
time, complication and giving least discomfort to the patient.