Document Detail

The medial-transverse approach for internal jugular vein cannulation: an example of lateral thinking.
MedLine Citation:
PMID:  22056111     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cannulation of the internal jugular vein (IJV) is traditionally performed using the central-longitudinal approach. Pneumothorax, carotid artery puncture, and failure to cannulate are uncommon, but by no means rare, complications. Ultrasound (US) guidance for IJV cannulation has reduced but not eliminated such complications.
TECHNIQUE: We herein introduce a new approach, coined the "medial-transverse approach" due to the perpendicular angle at which the introducer needle is advanced toward the IJV from the median to lateral direction.
DISCUSSION: The direction of the introducer needle is not toward the lung, thus virtually eliminating the possibility of pneumothorax. The image of the entire needle is seen when the US probe is typically orientated for a short-axis view of the IJV and carotid artery, thus improving the chance of uncomplicated IJV puncture. We have used this technique with apparent success in thousands of cases over the past 20 years in two different institutions.
CONCLUSION: A modified IJV cannulation technique that seems to have unique advantages over traditional approaches has been described. This technique is compatible with the blind and US-guided approaches.
Anthony M-H Ho; Christopher J Ricci; Calvin S H Ng; Lester A H Critchley; Adrienne K Ho; Manoj K Karmakar; Chi W Cheung; Siu K Ng
Publication Detail:
Type:  Journal Article     Date:  2011-11-03
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  42     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-13     Completed Date:  2012-04-12     Revised Date:  2014-04-10    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  174-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
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MeSH Terms
Catheterization, Central Venous / methods*
Jugular Veins / surgery*,  ultrasonography
Patient Positioning
Pneumothorax / prevention & control
Ultrasonography, Interventional
Comment In:
J Emerg Med. 2014 Mar;46(3):e99   [PMID:  24188610 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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