A prospective randomized control trial of ultrasound guided internal jugular venous cannulation: The short versus the long axis approach.

Abstract

Objectives: To compare the first pass success rate between long and short axis approaches in ultrasound guided IJV cannulation. Study Design: Prospective randomized controlled study. Setting: Department of Anesthesia and Intensive Care, Jinnah Hospital, Lahore. Period: Between 3^rd Mar, 2016 to 2^nd Sep, 2016. Material & Method: One hundred and ten patients admitted in the ICU were included in this study. Internal jugular vein was visualized ultrasonographically. In group A patients, long-axis view was used, while in group B patients, short-axis view was used to pass the needle. Under aseptic measures, US probe was placed on the neck and IJV viewed with either approach. During needle advancement if the needle penetrates the vein in the first attempt and blood flush-back is viewed, it was labeled as 1^st pass success. This first pass success rate was noted. Results: One hundred and ten patients (55 in each group) were included in the study. The mean age of the patients was found to be 33.89 ± 13.35 years in group A and 35.90 ± 14.10 years in group B. The primary outcome of the study was to compare 1^st pass success rate in both groups. The first pass success rate was 74.5% in group B (short-axis) and 61.8% in group A (long-axis); independent sample test showed non-significant (P=0.219). There is no difference in the frequency of 1^st pass success rate in short axis approach and long axis approach for Ultrasound-guided IJV cannulation.  Conclusion: Ultrasound-guided internal jugular venous cannulation with both approaches i.e. short-axis view and long-axis view have no significant difference in terms of first pass and therefore are equally successful.