Internal jugular vein cannulation: How much safety can we offer?

  • William F. Amaya Zuñiga a. Departament of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia. b. Universidad de los Andes, Bogotá, Colombia
  • Fernando Raffán Sanabria a. Department of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia. b. Universidad de los Andes, Bogotá, Colombia. c. Bogotá, Colombia, Universidad el Bosque. d. Transplant and Transfusion Committee of the Colombian Society of Anesthesiology, Bogotá, Colombia
  • Claudia Niño de Mejía a. Department of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia. b. Universidad de los Andes, Bogotá, Colombia. c. Universidad el Bosque, Bogotá, Colombia
  • Eduardo Hermida Department of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
  • Jorge Alvarado Sánchez Hospital Universitario Fundación Santa Fe de Bogotá, Universidad el Bosque, Bogotá, Colombia
  • María Conchita Solórzano Universidad de los Andes, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
  • Raphael Hernando Parrado Rodriguez a. Universidad de los Andes, Bogotá, Colombia. b. Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
  • Leonardo José León Nuñez Clinical Epidemiologist, Bogotá, Colombia
Keywords: Ultrasonography, Catheters, Patient safety, Catheterization, Central venous Anesthesia

Abstract

Introduction: Central venous catheterization, performed by the anatomical landmark technique, has a mechanical complication rate between 5% and 19%. This technique has been modified and new approaches have been implemented aiming to improve patient safety. With the introduction of ultrasonography in the clinical practice, and recently in central venous catheter insertion, the rate of complications has dropped over time.

Objective: To measure the clinical application of the algorithm "Successful ultrasound-guided internal jugular vein cannulation".

Methods: A descriptive, prospective, case series study. Patients over 18 years of age were selected, and the informed consent documentation was filled out appropriately. Patients with masses, anatomical abnormalities, insertion site infections and coagulopathy (International Normalized Ratio [INR] ≥ 2.0, platelet count ≤50.000) were excluded. Central venous cannulation was performed under ultrasound guidance in accordance with safety of the Fundación Santa Fe de Bogotá University Hospital (HUFSFB). Adjustment and validation of the algorithm was done according to an expert consensus in our department. A descriptive univariate analysis was conducted, and efficacy was determined on the basis of the number of attempts to achieve successful venous cannulation, and the incidence of complications.

Results: This series included 38 patients with a mean age of 62 years. In 97.4% of the cases, successful venous cannulation was achieved on the first attempt. Guidewire displacement was observed in one case, requiring a second attempt. The posterior jugular vein wall was punctured in two patients (5.2%), with no associated arterial vascular injury or pneumoth-orax.

Conclusions: This algorithm resulted in a high rate of successful first attempts and the prevention of potential complications, improving operational standards and healthcare quality for the patients.

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How to Cite
1.
Amaya Zuñiga WF, Raffán Sanabria F, Niño de Mejía C, Hermida E, Alvarado Sánchez J, Solórzano MC, Parrado Rodriguez RH, León Nuñez LJ. Internal jugular vein cannulation: How much safety can we offer?. Colomb. J. Anesthesiol. [Internet]. 2015Jan.1 [cited 2022Jul.6];43(1):76 -86. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/487

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Published
2015-01-01
How to Cite
1.
Amaya Zuñiga WF, Raffán Sanabria F, Niño de Mejía C, Hermida E, Alvarado Sánchez J, Solórzano MC, Parrado Rodriguez RH, León Nuñez LJ. Internal jugular vein cannulation: How much safety can we offer?. Colomb. J. Anesthesiol. [Internet]. 2015Jan.1 [cited 2022Jul.6];43(1):76 -86. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/487
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