Use of Static Ultrasound Guidance for Internal Jugular Vein Cannulation in Adult Cardiac Surgical Patients

Not Applicable

Completed

• Conditions: Adult Cardiac Surgical Patients
• Interventions: Device: Static Ultrasound technique; Procedure: landmark technique

• Registration Number: NCT02185664
• Lead Sponsor: Govind Ballabh Pant Hospital

Brief Summary

Cannulation of the internal jugular vein (IJV) for central venous access is a standard practice in cardiac surgery. In this study, the authors tested the hypothesis that using an ultrasound (US) scanner would increase the success of IJV cannulation and decrease the incidence of complications in adult cardiac surgical patients.

The study will include adult cardiac surgical patients, randomized into two groups (control vs. US). In the control group, IJV cannulation will be performed by the conventional landmark technique using Seldinger method. In the US group, the course of the IJV will be marked before cannulation using a 2 - 4 MHz transthoracic echocardiography probe. The success rate, number of attempts, cannulation time and complication rate will be compared for the two groups.

Detailed Description

Use of real time ultrasound has recently been recommended as the standard of care for insertion of central venous catheters. However, its usage is limited by various factors which include availability, space constraints and perceived lack of need according to surveys including cardiovascular anesthesiologists. We will conduct a prospective randomized controlled trial to compare the conventional landmark technique with the static ultrasound (US) technique that utilized the transthoracic echocardiography (TTE) ultrasound probe which is supplied along with the transesophageal echocardiography machines for internal jugular vein cannulation in adult cardiac surgical patients.

After ethical committee approval and patient consent, adult patients scheduled for elective cardiac surgery will be randomized to undergo internal jugular vein cannulation by either of the two methods: standard landmark technique (group A: control group), static US technique using the TTE probe (group B: ultrasound group). The success rate, number of attempts, total cannulation time and complication rate in the two groups will be compared.

Study Timeline

• Study Start: 2011-04
• Primary Completion: 2012-04
• Study Completion: 2012-04
• Status Verified: 2014-07
• Study First Submitted: 2014-07-04
• Study First Submitted QC: 2014-07-08
• Study First Posted: 2014-07-09
• Last Update Submitted: 2014-07-14
• Last Update Posted: 2014-07-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 201

Inclusion Criteria

• adult patients scheduled for elective cardiac surgery

Exclusion Criteria

• patients undergoing bidirectional Glenn shunt, Fontan surgery or emergency surgery
• local site infection
• presence of coagulopathy
• anatomical deformity of neck(burns, neck swelling, surgical scar)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Static Ultrasound technique	Static Ultrasound technique	Static ultrasound technique was used to assist internal jugular vein cannulation.
Landmark technique	landmark technique	The landmark technique is the standard technique used for internal jugular vein cannulation.

Primary Outcome Measures

Name	Time	Method
success	during internal jugular venous cannulation	Success was defined as location of the IJV by the finder needle within five attempts.

Secondary Outcome Measures

Name	Time	Method
Central venous cannulation time	at the time of internal jugular venous cannulation	Time to central venous cannulation (CVC) was defined as the time taken from the insertion of finder needle till de-airing and flushing of all the three ports of the triple lumen catheter.
ultrasound time	at the time of internal jugular vein cannulation	The duration of ultrasound was defined as the time between the placement of the probe on neck till the marking of the course of the vein on the skin.
total number of attempts by puncture needle	at the time of internal jugular vein cannulation	The total number of attempts taken by the puncture needle to enter the internal jugular vein were measured.
total cannulation time	at the time of internal jugular vein cannulation	control group: total cannulation time= central venous cannulation time ultrasound group: total cannulation time= central venous cannulation time+ ultrasound time
First attempt sucess	at the time of internal jugular vein cannulation	First attempt success was defined as location of the IJV by finder needle in the first attempt.
complication rate	at the time of central venous cannulation	The complication rate was calculated as a percentage of the total number of complications with respect to the sample size
number of attempts by finder/locator needle	at the time of internal jugular vein cannulation	The total number of attempts taken to locate the internal jugular vein using the locator/finder needle were measured.

Trial Locations

Locations (1)

Department of Anesthesia and Intensive Care, Govind Ballabh Pant Hospital; 🇮🇳 New Delhi, Delhi, India