Comparison Between Short Axis and Long Axis For Cannulation Of Internal Jugular Vein in Terms Of First Pass Success
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 10
- 试验地点
- 1
- 主要终点
- First-Pass Success Rate of Ultrasound-Guided Internal Jugular Vein Cannulation
研究概览
简要总结
To compare the frequency of first pass success by short axis versus long axis for cannulation of internal jugular vein.
详细描述
This randomized controlled trial aims to compare the effectiveness of short-axis and long-axis ultrasound-guided approaches for cannulation of the internal jugular vein (IJV) in terms of first-pass success. Central venous catheterization is a commonly performed procedure for invasive monitoring and administration of medications and fluids. Ultrasound guidance has improved the safety and success of IJV cannulation compared with traditional landmark-based techniques; however, uncertainty remains regarding the optimal ultrasound imaging approach.
A total of 60 eligible patients undergoing IJV cannulation will be enrolled and randomly allocated into two equal groups. Participants in Group A will undergo ultrasound-guided IJV cannulation using the short-axis approach, while participants in Group B will undergo cannulation using the long-axis approach. All procedures will be performed by the researcher under direct supervision using standardized ultrasound-guided techniques.
The primary objective is to compare the frequency of first-pass success between the two approaches. First-pass success is defined as successful IJV cannulation with a single skin puncture and without needle redirection. Baseline demographic and clinical characteristics will be recorded before the procedure. The findings of this study may help identify the preferred ultrasound-guided technique for maximizing first-pass success during IJV cannulation and potentially reducing procedure-related complications associated with multiple cannulation attempts.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 25 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 25-70 years.
- •Either male or female gender.
- •Undergoing cannulation of IJV.
排除标准
- •Patients who will be on hemodialysis therapy through double lumen catheter in IJV, assessed by reviewing previous medical records.
- •Patients who will have history of previous insertion of IJV line, assessed by reviewing previous medical records.
- •Patients with history of neck surgery, assessed by reviewing previous medical records.
- •Uncooperative patient.
- •Platelet count < 50,000/mm
- •International normalized ration 3 times upper normal limit (1.1).
研究组 & 干预措施
Group A (Short-Axis Approach)
In this approach, IJV will be visualized by placing the transducer in a transverse orientation on the patient neck at the level of the cricoid cartilage. The needle will be inserted at 60° to the vertical and will be advanced toward the vein employing gentle aspiration on the attached syringe. Entry to the vein will be confirmed by visualizing indentation of the anterior wall of the vein followed by blood in the syringe and by visualizing the tip of the needle inside the vein. Guide wire will be passed followed by dilator insertion and finally central vein line.
干预措施: Short-Axis Ultrasound-Guided Internal Jugular Vein Cannulation (Device)
Group B (Long-Axis Approach)
In this approach, the probe will be centered on the IJV and rotated through 90° in a clockwise direction resulting in long axis image of the vein. The needle insertion point will be directly beneath the most proximal end of the ultrasound probe. The needle will be inserted at 30° to the vertical and will be advanced toward the vein employing gentle aspiration. Entry to the vein will be confirmed by visualizing needle entry into the vein followed by aspiration of blood in the syringe. Guide wire will be inserted followed by dilator insertion and finally central vein line.
干预措施: Long-Axis Ultrasound-Guided Internal Jugular Vein Cannulation (Device)
结局指标
主要结局
First-Pass Success Rate of Ultrasound-Guided Internal Jugular Vein Cannulation
时间窗: Assessed during the cannulation procedure (within 5 minutes of initiation of cannulation).
First-pass success rate of ultrasound-guided internal jugular vein cannulation, defined as successful venous cannulation with a single skin puncture and needle pass.
次要结局
- Total Cannulation Success Rate(Assessed during the procedure (within 15 minutes).)
- Number of Needle Passes Required for Successful Cannulation(Recorded during the procedure.)
- Incidence of Hematoma Formation at the Cannulation Site(Assessed immediately after the procedure and within 24 hours.)
- Incidence of Posterior Vessel Wall Puncture(Assessed during the procedure.)
- Incidence of Pneumothorax Following Cannulation(Assessed within 24 hours following cannulation.)
- Overall Procedure-Related Complications(Assessed during the procedure and up to 24 hours after cannulation.)
研究者
Ahmad
PGR
University of Health Sciences Lahore