Ultrasound Cannulation of the Internal Jugular Vein

Cannulation of the internal jugular vein was achieved in all patients using ultrasound and in 425 of the patients (94.4%), the landmark technique (p <0.001) was used. Average access time (skin to vein) and the number of attempts were significantly reduced in the ultrasound group of patients compared to the landmark group (p<0.001). In the landmark group, puncture of the carotid artery occurred in 10.6% of patients, hematoma in 8.4%, hemothorax in 1.7%, pneumothorax in 2.4% and central venous catheter-associated blood stream infections in 16% which were all significantly increased compared to the ultrasound group (p<0.001).

There were no significant differences in gender, age, body mass index, left or right side of cannulation and in the presence of risk factors for difficult venous cannulation such as prior catheterization, limited sites for access attempts, previous difficulties during catheterization, previous mechanical complication, known vascular abnormality, untreated coagulopathy, skeletal deformity and cannulation during cardiac arrest between the two groups of patients. Furthermore, the physicians who performed the procedures had comparable experience in the placement of central venous catheters (p = non-significant).