Comparison of Short-Axis and Long-Axis Internal Jugular Vein Cannulation for First-Pass Success

Comparison Between Short Axis and Long Axis For Cannulation Of Internal Jugular Vein in Terms Of First Pass Success

To compare the frequency of first pass success by short axis versus long axis for cannulation of internal jugular vein.

This randomized controlled trial aims to compare the effectiveness of short-axis and long-axis ultrasound-guided approaches for cannulation of the internal jugular vein (IJV) in terms of first-pass success. Central venous catheterization is a commonly performed procedure for invasive monitoring and administration of medications and fluids. Ultrasound guidance has improved the safety and success of IJV cannulation compared with traditional landmark-based techniques; however, uncertainty remains regarding the optimal ultrasound imaging approach.

A total of 60 eligible patients undergoing IJV cannulation will be enrolled and randomly allocated into two equal groups. Participants in Group A will undergo ultrasound-guided IJV cannulation using the short-axis approach, while participants in Group B will undergo cannulation using the long-axis approach. All procedures will be performed by the researcher under direct supervision using standardized ultrasound-guided techniques.

The primary objective is to compare the frequency of first-pass success between the two approaches. First-pass success is defined as successful IJV cannulation with a single skin puncture and without needle redirection. Baseline demographic and clinical characteristics will be recorded before the procedure. The findings of this study may help identify the preferred ultrasound-guided technique for maximizing first-pass success during IJV cannulation and potentially reducing procedure-related complications associated with multiple cannulation attempts.

Inclusion Criteria:

• Age 25-70 years.
• Either male or female gender.
• Undergoing cannulation of IJV.

Exclusion Criteria:

• Patients who will be on hemodialysis therapy through double lumen catheter in IJV, assessed by reviewing previous medical records.
• Patients who will have history of previous insertion of IJV line, assessed by reviewing previous medical records.
• Patients with history of neck surgery, assessed by reviewing previous medical records.
• Uncooperative patient.
• Platelet count < 50,000/mm3.
• International normalized ration 3 times upper normal limit (1.1).