To compare the frequency of first pass success by short axis versus long axis for cannulation of internal jugular vein.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
10
Internal jugular vein cannulation performed under ultrasound guidance using the short-axis approach. The transducer is placed in a transverse orientation at the level of the cricoid cartilage, allowing visualization of the internal jugular vein and carotid artery during needle insertion.
Internal jugular vein cannulation performed under ultrasound guidance using the long-axis approach. The transducer is rotated to obtain a longitudinal view of the internal jugular vein, allowing continuous visualization of the needle during vessel cannulation.
National Hospital and Medical Center
Lahore, Punjab Province, Pakistan
First-Pass Success Rate of Ultrasound-Guided Internal Jugular Vein 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.
Time frame: Assessed during the cannulation procedure (within 5 minutes of initiation of cannulation).
Total Cannulation Success Rate
Total cannulation success rate, defined as successful placement of the internal jugular venous catheter.
Time frame: Assessed during the procedure (within 15 minutes).
Number of Needle Passes Required for Successful Cannulation
Total number of needle insertion attempts required to achieve successful ultrasound-guided internal jugular vein cannulation.
Time frame: Recorded during the procedure.
Incidence of Hematoma Formation at the Cannulation Site
Occurrence of hematoma at the internal jugular vein cannulation site following ultrasound-guided catheter insertion.
Time frame: Assessed immediately after the procedure and within 24 hours.
Incidence of Posterior Vessel Wall Puncture
Occurrence of unintended puncture of the posterior wall of the internal jugular vein during ultrasound-guided cannulation.
Time frame: Assessed during the procedure.
Incidence of Pneumothorax Following Cannulation
Occurrence of pneumothorax associated with ultrasound-guided internal jugular vein cannulation.
Time frame: Assessed within 24 hours following cannulation.
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Overall Procedure-Related Complications
Frequency of procedure-related adverse events, including hematoma, posterior vessel wall puncture, pneumothorax, or other complications occurring during or after ultrasound-guided internal jugular vein cannulation.
Time frame: Assessed during the procedure and up to 24 hours after cannulation.