Oblique Versus Transverse Orientation Approach for Internal Jugular Venous Cannulation in Pediatrics

University of Indonesia (UI)

Status

Completed

Conditions

Heart; Surgery, Heart, Functional Disturbance as Result

Pediatric ALL

Treatments

Procedure: internal jugular venous cannulation

Study type

Interventional

Funder types

Other

Identifiers

NCT05656937

IndonesiaUAnes109

Details and patient eligibility

About

this study aimed to compare oblique versus transverse orientation approach in jugular venous cannulation in term of cannulation success in pediatric heart surgery patients

Full description

Sixty patients randomised into two groups, 30 patients in experimental group (oblique orientation) and 30 patients in control group (transverse orientation). All cannulation took place in the operation room. Patients underwent general anesthesia and placed in supine position. Standard monitoring (electrocardiogram, non-invasive arterial pressure, pulseoxymetry) was carried out during the procedure for all patients. Before preparation of the skin, a pre-procedure ultrasound examination was performed to verify internal jugular vein patency, and its diameter was measured. Once the side had been chosen, the cannulation was performed following a sterile technique. All procedure were performed by Seldinger technique, with 22 Gauge IV catheter attached with 3 ml syringe as introducer needle. The vascular puncture was performed under ultrasound guidance, using a single-person technique. With transverse orientation, the transducer was placed transversally over the neck, and once the vein was visible in the middle of the ultrasound image, the needle was inserted in the plane perpendicular to the long axis of the transducer. With oblique orientation, the operator first obtained a transverse view of the vein and then rotated the transducer to 45 degrees (midway) between transverse and longitudinal view.

Enrollment

60 patients

Sex

All

Ages

3 to 12 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

patients age 3 months to 12 years old, weight 5-20 kg, male or female
who undergo heart surgery and indicated to have central venous cannulation
American Society of Anesthesiologist Physical Class 1-3
Family or representation of the patients agreed to participate in this study and sign informed consent

Exclusion criteria

history of surgery in the area of cannulation
already placed central venous cannulation <72 hours in the same venous
sign of infection, hematoma, emphysema, in the area of cannulation
history of cervical trauma
severe hemostatic disorder (International Normalized Ratio>2, thrombocyte <50.000, Prothrombin time>1.5 times, Activated Partial Thromboplastin Time > 1.5 times