Comparison of an ultrasound-guided-technique versus a landmark guided technique for internal jugular vein cannulation

Background: Central venous cannulation is a relatively common procedure in many branches of medicine particularly in anaesthesia and intensive care medicine. The purpose of this study was compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in cardiovascular surgery patients.Methods: One hundred cardiovascular surgery patients (65 males, 35 females; range 22-65 years) who had internal jugular cannulation between December 2010 - March 2011 in our clinic were investigated prospectively. Patients were randomized into two groups; internal juguler cannulation was performed with ultrasound guided in group U(n=50), and performed with anatomic landmark guided in group A(n=50). Number of attempts until successful catheterization, time to successful catheterization , complications, the demographics of each patient and catheter staying day were recorded.Results: There were no significant differences in the demographic features between the two groups. Number of attempts for successful catheterization was statistically lower in group U (1,1±0,5) than group A (2,2±1,6). Time to successful catheterization was statistically lower in group U (109,4±30,4) than group A (165,9±91,5). There was no significant differences in the complications between the two groups (p=0.057). Four patients had arterial punction [group U (n=0) and group A (n=4) ] and 2 patients had hematoma [ group U (n=1) and group A (n=1) ].Conclusion: The findings of this study indicates that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of attempts.Keywords: Central venous cannulation; Central venous catheter, Jugular vein; Ultrasonography; Landmark; Complication.