Document Detail

Ultrasound-guided cannulation and endocavitary electrocardiography placement of internal jugular vein catheters in uremic patients: the importance of routine chest X-ray evaluation.
MedLine Citation:
PMID:  17638257     Owner:  NLM     Status:  In-Data-Review    
The NKF-DOQI guidelines recommend performing chest-X-ray(CXR) after subclavian and internal jugular vein insertion prior to catheter use. This is to exclude complications such as a pneumothorax before starting hemodialysis. Indication of a central venous dialysis catheter was based on the historic use of the subclavian vein for placement of these catheters and upon the reported incidence of pneumothorax after this approach of between 1% to 12.4%. In contrast, the incidence of these complications using the internal jugular vein (IJV) is much lower (< 1%). We report our experience in ultrasound-guided cannulation of the right IJV for dialysis vascular access in 527 uremic patients and central catheter placement by endocavitary electrocardiography (EC-ECG). Fluoroscopy was not utilized. In the first hundred cases, all patients underwent CXR. Subsequently, because of total absence of complications and catheter tip malpositioning, the CXR control was carried out only in selected cases (repeated cannulation of the jugular vein or absence of P wave). We believe that only in selected cases should a pCXR be performed before starting hemodialysis sessions, and that our method using the right IJV, ultrasound-guided puncture of the vessel, and catheter placement by EC-ECG is a safe and simple technique that avoids the need for CXR control.
F Cavatorta; A Zollo; S Galli; M Mij; D Dolla
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of vascular access     Volume:  2     ISSN:  1129-7298     ISO Abbreviation:  J Vasc Access     Publication Date:    2001 Apr-Jun
Date Detail:
Created Date:  2007-07-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100940729     Medline TA:  J Vasc Access     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  37-9     Citation Subset:  -    
Department of Nephrology and Dialysis, General Hospital, Imperia - Italy.
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