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. 2020 Mar;64(3):193-198.
doi: 10.4103/ija.IJA_785_19. Epub 2020 Mar 11.

A prospective, randomised, comparative study to evaluate long axis, short axis and medial oblique axis approach for ultrasound-guided internal jugular vein cannulation

Jatin Lal  1 , Mamta Bhardwaj  1 , Meenakshi Verma  1 , Teena Bansal  1
Affiliations

A prospective, randomised, comparative study to evaluate long axis, short axis and medial oblique axis approach for ultrasound-guided internal jugular vein cannulation

Jatin Lal et al. Indian J Anaesth. 2020 Mar.

Abstract

Background and aims: The Ultrasound (USG)-guided internal jugular vein (IJV) cannulation can be performed using different approaches like short axis (SAX), long axis (LAX), oblique axis (OAX) or medial oblique axis (M-OAX). We aimed to determine which view was optimal for IJV cannulation.

Methods: After ethical committee approval and written informed consent, this prospective, randomised, controlled trial was conducted on 108 patients. Patients were allocated into one of the three groups: A (SAX), B (LAX) and C (M-OAX approach) for USG-guided IJV cannulation. The number of needle passes, the success of IJV cannulation and its diameter, venous access time, guidewire time, catheterisation time and complications if any were recorded. Statistical analysis was performed by SPSS version 17.0.

Results: First needle pass success rate was highest in M-OAX (97.2%) followed by SAX (88.9%) and then LAX (77.8%) but it was statistically insignificant among the groups. Mean venous access, guidewire insertion and catheterisation time were shortest in M-OAX followed by SAX and then LAX approach. It was statistically significant between LAX and SAX and between LAX and M-OAX group. (P < 0.001). The carotid puncture was noticed in two patients in the LAX group. The overall success rate and the number of needle passes were comparable among the groups.

Conclusion: The M-OAX approach is a safe and effective technique for USG-guided IJV cannulation when compared to SAX and LAX approaches.

Keywords: Internal jugular vein cannulation; long axis; medial oblique axis; short axis; ultrasound.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Short axis approach with guidewire seen as white dot
Figure 2
Figure 2
Long axis approach showing guidewire seen as a bright line
Figure 3
Figure 3
Medial oblique axis view showing both artery, vein and path of the guidewire as a bright line
See this image and copyright information in PMC

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