COMPARISON OF THREE APPROACHES FOR ULTRASOUND GUIDED INTERNAL JUGULAR VEIN CANNULATION: A PROSPECTIVE RANDOMIZED STUDY

Internal jugular vein (IJV)cannulation is the most often used central venous cannulation technique. Theuse of ultrasonography for IJV access offers prompt, secure, and reliableguidance for needle placement. In comparison to the landmark technique, it alsoleads to a higher percentage of cannulation that are successful on the firsttry, a shorter average cannulation time, and a decrease in mechanical problems.Several approaches can be used for ultrasound guided IJV cannulation, includingthe short axis view (SAX), long axis view (LAX), combination of short and longaxes views (SAX initially, then rotation to LAX to see needle entry into thevein) namely oblique axis view (OAX) and medial oblique axis view (M-OAX). Eachmethod has advantages and drawbacks of its own.

The primary objective of the study is to assessand compare the three approaches for ultrasound guided successful internaljugular cannulation on successful first needle pass and the secondary objectiveis to compare number of needle passes, duration of cannulation [Time fromstarting of insertion of introducer needle to the end of IJV cannula placement(notincluding the suture and fixation time)], and incidence of complications namelycarotid artery puncture, posterior venous wall puncture, local haematoma formation, puncture site bleeding, catheter misplacement,haemothorax, pneumothorax, arrhythmias, thrombosis and embolism