COMPARISON OF ULTRASOUND GUIDED OUT OF PLANE SHORT AXIS METHOD / IN PLANE LONG AXIS METHOD FOR RIGHT INTERNAL JUGULAR VENOUS CANNULATION IN TERTIARY CARE HOSPITAL.

Abstract

Background Ultrasound (US) guidance for Internal Jugular Venous (IJV) placement is considered gold standard in localization and cannulation, making the procedure safer with less complications. To compare the Aims & Objectives short-axis/out-of-plane (SAX) with the long-axis/in-plane (LAX) technique for US-guided CVC insertion in internal jugular vein in intensive care practice in terms of safety and efcacy. In this Retrospective observa Methods tional study we have enrolled total 232 patients admitted in our tertiary care hospital during June 2016 to June 2020 at NHLMMC, VS & SVP hospital, Ahmedabad, India after taking written informed consent and explaining the procedure to patient & their relatives. Randomisation was done at time of procedure by odd & even numbers put in opaque sealed envelope. There were two groups: Group S which included 116 patients in whom the out of plane short axis SAX technique was performed and Group L which also included 116 patients in whom the in plane LAX technique was performed for US-guided IJV insertion in Right internal jugular vein. The primary outcome was rst-attempt success rate of both the approaches for US-guided vascular catheterization. The secondary outcomes were total success rate, which was dened as successful venous cannulation without complication; cannulation time calculated in seconds; the number of attempts and complications (hematoma and arterial puncture). US-guided venous cannulation was Results successful without complications in 99% patients in group S & 95% in group L. Venous access time, cannulation time, and US imaging time were signicantly lower in the group S than in the group L (P<0.05). Complications in both groups had no statistically signicant difference. Hematoma formation was evident in one patient in group L. Multiple puncture was more in LAX group with no signicant difference. Conclusion: Out of plane SAX approach is better than in plane LAX approach for ultrasound guided IJV cannulation.