Comparison of Ultrasound Versus Non Ultrasound based Techniques for Internal Jugular Venous Cannulation in Cardiac Surgical Patients: A Prospective Randomised Controlled Trial

Abstract

Objectives: The study aims to compare the success rate, time for cannulation and complications of ultrasound-guided internal jugular venous cannulation versus blind landmark-based technique in adult cardiac surgical patients. The primary objective is to compare the success rate between USG group and landmark group. The secondary objectives are to determine the complications, time for cannulation and compare between the two groups. Materials and Methods: In a prospective randomized controlled doubleblinded trial, 122 adult patients undergoing elective cardiac surgery were split up into two pairs. Group U (ultrasound-guided technique) and Group N (non-ultrasound-based technique). We assessed first attempt success rate, number of attempts required, time for cannulation and complications (e.g., carotid artery puncture, hematoma, pneumothorax). Results: Demographics between Group U and N were similar. Ultrasound-guided technique exhibited higher first attempt success rate (91.8% vs. 75.4%, p=0.014), fewer attempts (1.10 vs. 1.61, p=0.017) and fewer complications (carotid artery puncture: 1.6% vs. 6.6%, p=0.042; hematoma: 1.6% vs. 6.6%, p=0.042) compared to the non-ultrasound-based technique. Group N had a higher failure rate (6.6% vs. 0%, p=0.042). No significant difference in cannulation time was observed (U: 217.02 seconds vs. N: 214.31 seconds, p=0.92). Conclusion: Ultrasound-guided internal jugular venous cannulation yields better first attempt success, fewer attempts, and fewer complications than nonultrasound-based IJV cannulation. But there wasn't any obvious distinction in cannulation time between the two sets.

Keywords

• ultrasound
• internal jugular venous cannulation
• cardiac surgery
• success rate
• complications