Association between the internal jugular vein/common carotid artery ratio and the first-attempt success rate of landmark-guided right internal jugular vein cannulation in patients undergoing elective surgeries under general anesthesia – a prospective observational study

According to prior studies, the internal jugular vein/common carotid artery (IJV/CCA) ratio can be correlated to the central venous pressure.1,2 In resource-limited settings, central venous cannulations (CVC) are carried out by anatomical landmark-guided techniques. Because of their accessibility and generally low likelihood of complications, the jugular veins are among the most often used locations for central venous access. The right IJV is the most commonly used vein for central venous catheterization due to its larger size, and runs more superficially when compared to the left IJV. Common carotid artery puncture is the most feared complication while performing IJV cannulation. A higher IJV/CCA ratio indicates that the size of the IJV is larger when compared to the CCA. The relationship between the IJV/CCA ratio and the first attempt success of landmark-guided IJV has not been studied. We hypothesize that a higher IJV/CCA ratio results in higher success of cannulating the IJV with fewer complications like CCA puncture.