Study between Ultrasound Guided Technique and Conventional Landmark Technique for Internal Jugular Vein Cannulation: A Randomised Controlled Trial

Abstract

Introduction: Internal Jugular Vein (IJV) cannulation is carried out for administration of fluids over a prolonged period, massive blood transfusion, antibiotics, inotrope infusions, total parenteral nutrition, haemodynamic monitoring, haemodialysis and in patients in whom there is difficult peripheral venous access. Aim: To compare success rate, number of attempts, time required for successful cannulation, and complications between Ultrasonography (USG) guided IJV cannulation and conventional landmark technique. Materials and Methods: Ninety patients scheduled for IJV cannulation were randomly divided into two groups. Forty-five patients in Group A and 45 patients in Group B were cannulated with USG guidance, and landmark technique respectively. Primary outcome measures were number of attempts, time required for successful catheterisation, and success rate whereas secondary outcome measures were complications. Comparison of quantitative and qualitative variables between groups was done using unpaired student’s t-test and chi-square test or Fisher’s-exact test respectively. R esults: In Group A, all were successfully cannulated whereas, in Group B, 43 (95.6%) were successfully cannulated (p=0.494). The percentage of patients who required ≥2 attempts was significantly higher in Group B (97.8%) compared to Group A (60.5%). Mean time required for successful cannulation was significantly higher in Group B (4.7 m) compared to Group A (4.2 m). The complications were significantly less in Group A compared to Group B. Conclusion: USG guided cannulation of IJV decreases access time, reduces attempts, and complication rates. USG guided technique may be preferred for cannulation of IJV.

Keywords

• blood transfusion
• complications success rate
• inotrope infusions