Comparison of Three Different Approaches to Ultrasound-guided Internal Jugular Vein Cannulation: A Randomised Clinical Study

Abstract

Introduction: The standard approaches to ultrasound-guided central line insertion by Short Axis (SAX) and Long Axis (LAX) have limitations. The Medial Oblique Axis (M-OAX) approach allows visualisation of the length of the needle in real-time along with both the artery and vein. Aim: To compare the three approaches for ultrasound-guided right Internal Jugular Vein (IJV) cannulation with respect to ease of access and complications. Materials and Methods: A total of 171 patients scheduled to undergo right IJV cannulation were divided equally into three groups-SAX (Group-1), LAX (Group-2), and M-OAX (Group-3). They were compared with respect to first pass success, Venous Access Time (VAT), guide wire insertion time, catheterisation time, and complications. Continuous variables were compared with Analysis of Variance (ANOVA) test. Categorical variables were analysed using the Chi-square test. The p-value 0.05). Conclusion: The medial oblique approach to IJV cannulation combines the advantages of both LAX and SAX and is a safer alternative with easier and faster venous access.

Keywords

• carotid artery
• central venous catheterisation
• ultrasonography