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Not yet recruiting NCT07691554

Comparison of Short-Axis and Long-Axis Internal Jugular Vein Cannulation for First-Pass Success

No phase Interventional Cannulation of Internal Jugular Vein

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Short-Axis Ultrasound-Guided Internal Jugular Vein Cannulation, Long-Axis Ultrasound-Guided Internal Jugular Vein Cannulation.
Who it may be relevant to
Registry conditions: Cannulation of Internal Jugular Vein. Basic parameters: 25 years — 70 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Pakistan
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

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Official title

Comparison Between Short Axis and Long Axis For Cannulation Of Internal Jugular Vein in Terms Of First Pass Success

Overview

To compare the frequency of first pass success by short axis versus long axis for cannulation of internal jugular vein.

Detailed description

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.

Interventions

  • Device Short-Axis Ultrasound-Guided Internal Jugular Vein Cannulation
    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.
  • Device Long-Axis Ultrasound-Guided Internal Jugular Vein Cannulation
    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.

Primary outcome measures

  • First-Pass Success Rate of Ultrasound-Guided Internal Jugular Vein Cannulation [Time frame: Assessed during the cannulation procedure (within 5 minutes of initiation of cannulation).]
Secondary outcome measures (6)
  • Total Cannulation Success Rate [Time frame: Assessed during the procedure (within 15 minutes).]
  • Number of Needle Passes Required for Successful Cannulation [Time frame: Recorded during the procedure.]
  • Incidence of Hematoma Formation at the Cannulation Site [Time frame: Assessed immediately after the procedure and within 24 hours.]
  • Incidence of Posterior Vessel Wall Puncture [Time frame: Assessed during the procedure.]
  • Incidence of Pneumothorax Following Cannulation [Time frame: Assessed within 24 hours following cannulation.]
  • Overall Procedure-Related Complications [Time frame: Assessed during the procedure and up to 24 hours after cannulation.]

Eligibility criteria

Inclusion criteria

  • Age 25-70 years.
  • Either male or female gender.
  • Undergoing cannulation of IJV.

Exclusion criteria

  • Patients who will be on hemodialysis therapy through double lumen catheter in IJV, assessed by reviewing previous medical records.
  • Patients who will have history of previous insertion of IJV line, assessed by reviewing previous medical records.
  • Patients with history of neck surgery, assessed by reviewing previous medical records.
  • Uncooperative patient.
  • Platelet count < 50,000/mm3.
  • International normalized ration 3 times upper normal limit (1.1).

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Randomized
Model
Parallel assignment
Masking
Single blind
Primary purpose
Prevention

Study locations

Pakistan · 1 center
  • National Hospital and Medical Center — Lahore

Publications

  • Shrestha GS, Gurung A, Koirala S. Comparison between long- and short-axis techniques for ultrasound-guided cannulation of internal jugular vein. Ann Card Anaesth. 2016 Apr-Jun;19(2):288-92. doi: 10.4103/0971-9784.179629. PMID 27052071
  • Rath A, Mishra SB, Pati B, Dhar SK, Ipsita S, Samal S, Azim A. Short versus long axis ultrasound guided approach for internal jugular vein cannulations: A prospective randomized controlled trial. Am J Emerg Med. 2020 Apr;38(4):731-734. doi: 10.1016/j.ajem.2019.06.010. Epub 2019 Jun 14. PMID 31230925
  • Tolson OW. Should central venous pressure be used to guide critical care management? Br J Hosp Med (Lond). 2022 Oct 2;83(10):1-3. doi: 10.12968/hmed.2022.0167. Epub 2022 Oct 11. PMID 36322446

Identifiers

NCT: NCT07691554 · 06-10-2023

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗