A Comparative Study of Internal Jugular Vein Cannulation under Ultrasound Guidance Using Short Axis or Long Axis View Approach

Anaesthesiologists most commonly perform the procedure of internal jugular vein cannulation(IJV) in emergency and also in elective cases. With the use of ultrasound guidance placement of guide wire and catheter into the internal jugular vein has been made easy, safe and with less complications.

The aim of the study was to compare IJ vein cannulation under ultrasound guidance with respect to Short and Long axis (SA and LA) view approaches.

Patients who may require central venous cannulation for undergoing surgery and will be in intensive care unit were randomized using computer generated randomization for ultrasound guided cannulation into one of short axis and long axis (SA and LA) approaches group. Success rate of first pass, number of needle attempts made, guide wire insertion time, catheter placement time and complications were noted for each procedure.

Successful cannulation of IJV was achieved in all the patients. Significant results were not noted among the two groups with respect to demographic profile of the patient, catheter placement time, rate of carotid artery puncture. Whereas a significant result was noted in terms of success rate of first pass (97% in SA v/s 53% in LA, P-0.0001), number of needle attempts (mean of 1.05±0.18 in SA v/s 1.55±0.68 in LA, P-0.0001), guide wire insertion time (mean of 43.20±5.64 in SA v/s 74.83±39.36 in LA).

We conclude from the above study that short axis view approach is better with respect to success rate of first pass, number of needle attempts and guide wire insertion time than long axis view approach for internal jugular vein cannulation under ultrasound  guidance.