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ROC curve of the central venous pressure for the visible respiratory jugular venodilation. Area under the curve is given inside the ROC curve. ROC curve, receiver operator characteristic curve. doi:10.1371/journal.pone.0103089.g004
Source publication
Background
Although ultrasonography is recommended in internal jugular vein (IJV) catheterization, the landmark-guided technique should still be considered. The central landmark using the two heads of the sternocleidomastoid muscle is widely used, but it is inaccurate for IJV access. As an alternative landmark, we investigated the accuracy of the n...
Context in source publication
Citations
... After sterile preparation, an ultrasound probe (Colour Doppler ultrasound machine Sonosite) covered with ultrasonic gel and wrapped in a sterile sheath, was placed at the level of cricoid cartilage and then moved laterally. [12] After infiltration with 2 mL of 2% xylocaine, the RIJV was cannulated by modified Seldinger's technique. A 7cm 18-gauge needle (Ven X central venous catheter set-product No. CE-2460) was introduced at an angle of 45° at the level of the cricoid cartilage. ...
Background and aims:
The position of the tip of the central venous catheter (CVC) is important to minimise complications. The aim of our study was to compare modified Peres' height formula and landmark method using distance between puncture site and right third intercostal space (PS-RTICS) and to develop a reliable formula for correct positioning of tip of the CVC.
Methods:
This prospective, randomised study was conducted on 400 patients of either gender, of age 18 years and older, scheduled to undergo right internal jugular venous cannulation. Depending on the technique used for deciding the length of CVC to be inserted, the patients were randomly allocated into two groups: Group A, using modified Peres' height formula, that is, height of patient (cm)/10-2 and Group B, using distance between PS-RTICS and subtracting one from it, that is (PS-RTICS)-1. The carina was taken as the landmark for optimum insertion of CVC, which was confirmed on postprocedure chest X-ray. Data so obtained were tabulated and analysed. P<.05 was considered statistically significant for correlation and regression coefficients.
Results:
In group A, the mean length of catheter inserted was 15.18 ± 0.73 cm and the catheter tip was found to be 2.41 ± 0.85 cm distal to carina (P =0.001). Over-insertion was found in 98.45% patients in group A. In group B, the mean length of catheter inserted was 14.12 ± 0.85 cm and the catheter tip was found to be 0.20 ± 1.18 cm distal to carina.
Conclusion:
Though both landmark and modified Peres' height formula has low accuracy, landmark technique is superior in predicting correct depth of right internal jugular venous cannulation catheter.
... The level of the CC approximates the level of the apex of the sternocleidomastoid muscle triangle, both of which are located on the midsection of the longitudinal axis of the neck. Therefore, IJV access on the CC level might offer more advantages than access to the upper and inferior neck segments (25). ...
Objective
Internal jugular vein puncture or cannulation is far more difficult in children compared with adults. Anthropometric measures of the internal jugular vein acquired by two-dimensional ultrasound are useful in the practice of puncture and catheterization. The aim of this study is to measure anthropometric parameters of bilateral internal jugular veins in children and to determine the best puncture site based on these parameters.
Materials
A total of 107 pediatric patients undergoing elective operation were included. Ultrasound-visible evaluation of bilateral internal jugular veins was used to obtain the depth from skin, maximum antero-posterior diameter, and cross-sectional area at the levels of the superior border of thyroid cartilage and cricoid cartilage. Statistical analysis was performed using these anthropometric data and demographic variables of all studied pediatric patients, such as age, height, and weight.
Results
A very weak correlation was noted between the depth, maximal antero-posterior diameter, and cross-sectional area of both internal jugular veins and the age, height, weight, and body surface index of all included children. All Pearson's R correlation coefficients were <0.45. The largest diameter and cross-sectional area were in the right internal jugular vein at the cricoid cartilage level ( p < 0.01) followed by the left internal jugular vein at this level ( p < 0.01). In addition, the internal jugular vein at the cricoid cartilage level was more superficial than that of the superior border of the thyroid cartilage ( p < 0.01).
Conclusion
The right internal jugular vein at the cricoid cartilage level is the best site for puncture. The most appropriate alternative site is the left internal jugular vein on the same level. Better correlation was not observed between the anthropometric parameters of the internal jugular vein and children's biological characteristics. This finding should be confirmed in a larger-scale demographical study in the future.
... [13][14][15] Although clinicians have recommended that subclavian vein catheterization should be performed under ultrasound guidance, it has been reported that its clinical use is limited. [16] In addition, ultrasound devices may not always be universally available. [17] The other disadvantages of using ultrasound can be considered as the requirement of a high level of training, reduced ability of catheterization using the conventional technique over time, [18] and the cost and timeconsuming preparation process in emergency cases. ...
BACKGROUND: The femoral vein cannulation is essential for vascular access and finding it by just relying on the femoral artery pulsation can be challenging in a certain condition. V technique is a new technique to identify the femoral vein’s cannulation site based on topographic anatomy without relying on femoral artery pulsation. AIM: This study was aimed to compare V technique and arterial palpation technique accuracies in identifying the femoral vein’s cannulation site. METHODS: This study was a cross-sectional study on 115 adult patients aged 18–65 years old with body mass index 18–25 kg/m2 who underwent elective surgery in Cipto Mangunkusumo National General Hospital on February-March 2020. After ethical approval and informed consent, the distance of the femoral vein’s cannulation site identified by both techniques with the skin projection of the femoral vein diameter identified by ultrasonography (USG) were compared in all subjects. Accuracy was defined when the femoral vein’s cannulation sites identified by both techniques were within the skin projection of femoral vein diameter identified by USG. Data were collected and analyzed using SPSS ver 20. RESULTS: The accuracy of the V technique in determining the femoral vein’s cannulation site was 93.9%, while the accuration of the femoral artery pulsation technique was 96.5%. Mcnemar analysis showed no difference in both techniques’ accuracy (p = 0.549). There was a statistically significant positive correlation between the distance of the femoral vein cannulation site predicted by both techniques with the skin projection of the femoral vein midpoint (r = 0.548; p < 0.001). CONCLUSION: V technique’s accuracy was not significantly different from the femoral artery pulsation palpation technique’s accuracy in identifying the femoral vein cannulation site.
Background:
Landmark-guided internal jugular vein cannulation is difficult for pediatric patients but useful, especially when ultrasound equipment is unavailable. Therefore, it is important to define the adjacent anatomic characteristics of the pediatric internal jugular vein.
Methods:
In 210 children the course of the internal jugular vein, and common carotid and vertebral arteries was measured from the level of the cricoid cartilage to the supraclavicular area using ultrasound.
Results:
From the level of the cricoid cartilage to the supraclavicular area, vessel diameter increased with internal jugular vein increasing by 12%, and common carotid and vertebral arteries increasing by 5% each. From the level of the cricoid cartilage to the supraclavicular area, the number of patients with a medial common carotid artery position relative to the internal jugular vein increased, whereas those with a lateral position decreased; the number of patients with nonoverlapped common carotid artery-internal jugular vein increased, and those with totally overlapped decreased. In contrast, the overlapping status of vertebral artery-internal jugular vein changes oppositely. More than 97.14% of the vertebral artery lies lateral to the internal jugular vein at these levels. The minimal vertebral artery-internal jugular vein depth decreased from 0.46±0.20 to 0.37±0.19 cm. The angle from the internal jugular vein line to the horizontal line of the body was 83.35±9.04 degrees.
Conclusions:
The common carotid artery and internal jugular vein are farther apart as one moves down the neck, whereas the vertebral artery and internal jugular vein are getting together. Additionally, the diameter of the internal jugular vein increased.
