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

Официальное название

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

Обзор

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

Подробное описание

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.

Вмешательства

• Устройство 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.
• Устройство 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.

Первичные конечные точки

• First-Pass Success Rate of Ultrasound-Guided Internal Jugular Vein Cannulation [Срок оценки: Assessed during the cannulation procedure (within 5 minutes of initiation of cannulation).]

Вторичные конечные точки (6)

• Total Cannulation Success Rate [Срок оценки: Assessed during the procedure (within 15 minutes).]
• Number of Needle Passes Required for Successful Cannulation [Срок оценки: Recorded during the procedure.]
• Incidence of Hematoma Formation at the Cannulation Site [Срок оценки: Assessed immediately after the procedure and within 24 hours.]
• Incidence of Posterior Vessel Wall Puncture [Срок оценки: Assessed during the procedure.]
• Incidence of Pneumothorax Following Cannulation [Срок оценки: Assessed within 24 hours following cannulation.]
• Overall Procedure-Related Complications [Срок оценки: Assessed during the procedure and up to 24 hours after cannulation.]

Критерии участия

Критерии включения

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

Критерии исключения

• 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).

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Профилактика

Центры проведения

Пакистан · 1 центр

• National Hospital and Medical Center — Lahore

Публикации

• 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

Идентификаторы

NCT: NCT07691554 · 06-10-2023

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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