Logo

Central Venous Cannulation of the Internal Jugular Vein Both With and Without Ultrasound Guidance in Iran

Author(s):
Hamidreza Karimi-SariHamidreza Karimi-Sari1,*, Niloofar NikjooNiloofar Nikjoo2
1Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
2Medical Student Research Committee (MSRC), Iran University of Medical Sciences, Tehran, Iran


Anesthesiology and Pain Medicine:Vol. 6, issue 5; e39256
Published online:Jul 26, 2016
Article type:Letter
Received:May 16, 2016
Accepted:Jun 19, 2016
How to Cite:Hamidreza Karimi-SariNiloofar NikjooCentral Venous Cannulation of the Internal Jugular Vein Both With and Without Ultrasound Guidance in Iran.Anesth Pain Med.2016;6(5):e39256.https://doi.org/10.5812/aapm.39256.

Dear Editor,

We read with great interest the article recently published in your journal about central venous cannulation of the internal jugular vein using ultrasound (US)-guided and anatomical landmark (AL) techniques in Iran (1). In their study, Fathi et al. concluded that the AL technique is superior to the US-guided method in Iran. As you are aware, the physician’s skill is the most important confounder for this outcome; others include the procedure’s location and the patient’s condition.

We conducted a similar study in 100 patients who were referred to our emergency department (ED) (2). Emergency medicine residents performed the cannulations in our study; this procedure differed from that of Fathi et al., where anesthesiologists placed the cannulations in the operating room (OR). We concluded that the US-guided method was superior, while Fathi et al. found no significant differences between the two groups. The anesthesiologists in their study were more experienced with the AL method, but our study had no procedure for selecting a specific method. We also measured the access time, which was significantly lower in the US-guided group compared to the AL group. In our study, the mean access time in the US-guided group was greater than that reported by previous studies, which reflects the inexperience of our resident physicians in the US-guided method. However, the cannulation time in our AL group was faster than that reported in earlier studies, which indicates that our physicians have more experience in cannulation using anatomical landmarks. Therefore, in addition to promoting the US-guided method, we should also offer training in the AL method. Our study also found that patients’ gender, body mass index, and the side of cannulation (right/left) are other confounders that should be matched between the groups. These confounding factors must be controlled in future studies. We also suggest that similar studies should be conducted in different places (e.g., the OR, wards, and the ED) and by other specialists (e.g., surgery residents or attendings) before drawing further conclusions.

References

  • 1.
    Fathi M, Izanloo A, Jahanbakhsh S, Gilani MT, Majidzadeh A. Central venous cannulation of the internal jugular vein using ultrasound-guided and anatomical landmark techniques. Anesth Pain Med. 2016;In Press(In Press). https://doi.org/10.5812/aapm.35803.
  • 2.
    Karimi-Sari H, Faraji M, Mohazzab Torabi S, Asjodi G. Success rate and complications of internal jugular vein catheterization with and without ultrasonography guide. Nurs Midwifery Stud. 2014;3(4). e23204. [PubMed ID: 25741514].
comments

Leave a comment here


Crossmark
Crossmark
Checking
Share on
Metrics

Purchasing Reprints

  • Copyright Clearance Center (CCC) handles bulk orders for article reprints for Brieflands. To place an order for reprints, please click here (   https://www.copyright.com/landing/reprintsinquiryform/ ). Clicking this link will bring you to a CCC request form where you can provide the details of your order. Once complete, please click the ‘Submit Request’ button and CCC’s Reprints Services team will generate a quote for your review.
Search Relations

Author(s):

Related Articles