To Compare the In-plane and Out of Plane Ultrasound Guided Approach for Internal Jugular Vein Cannulation in the Patients Undergoing Elective Cardiac Surgery.

Aga Khan University Hospital, Pakistan

Status: Completed

Conditions: Ultrasonography; Cardiac Surgical Procedures; Catheterization, Central Venous

Treatments: Procedure: In-plane Axis; Procedure: Out of plane Axis

Study type: Interventional

Funder types: Other

Identifiers

NCT04840810

AgaKhanUH

Details and patient eligibility

About

The insertion of central venous catheters (CVCs) has become an integral part of management of a critically ill patient. Access to the central vein may be required for the administration of hyper osmotic or vasoactive compounds, parenteral nutrition, and rapid infusion of large volumes of fluid or for the continuous or intermittent monitoring of biochemical or physiological parameters. Central venous catheter insertion is also indicated when the insertion of a peripheral line is not possible. Traditionally, CVC insertions have been performed using the landmark technique.

Considering the number of CVCs being inserted every day, this can amount to a large number of complications. Efforts to minimize and prevent the occurrence of complications should be a routine component of quality improvement programs. There is an increasing body of evidence supporting the use of ultrasound guidance for CVC placement.

This makes the strong rationale to conduct this research thus the aim of this study is to evaluate the real benefits i.e outcome of Long versus Short Axis ultrasound guided approach for internal jugular vein cannulation in the patient for elective cardiac surgery as central venous cannulation (CVC).

Full description

OBJECTIVE: To compare the in plane and out of plane ultrasound guided approach for internal jugular vein cannulation in the patients undergoing elective cardiac surgery.

Ultrasound-guided central vein cannulation has many advantages, giving the operator the possibility of choosing the most appropriate and safest venous access on the basis of ultrasound assessment, performing a 100% safe insertion, ruling out malposition or pleuropulmonary damages, during and after the procedure.

There is an increasing body of evidence supporting the use of ultrasound guidance for CVC placement.

This makes the strong rationale to conduct this research thus the aim of this study is to evaluate the real benefits i.e outcome of Long versus Short Axis ultrasound guided approach for internal jugular vein cannulation in the patient for elective cardiac surgery as central venous cannulation (CVC).

Enrollment: 80 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients admitted for elective cardiac surgery.
• Age between 18 - 75 years.

Exclusion criteria

• BMI more than 30.
• Haemodynamically unstable.
• Patient with abnormal coagulation profile(INR>1.5 or Platelet counts<50,000).
• Patient with a short neck.
• Patient with carotid Atherosclerosis proven on ultrasound.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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80 participants in 2 patient groups

Out of plane/ short axis central venous cannulation

Active Comparator group

Description:

In a short-axis view, the image plane is perpendicular to the course of the vessel and to the needle (needle is "out of plane"). The vessel appears as an anechoic circle on the screen of ultrasound with the needle visualized as a hyperechoic point in cross-section. The central venous cannulation was done in out of plane axis.

Treatment:

Procedure: In-plane Axis

In-plane/long axis central venous cannulation

Active Comparator group

Description:

In a long-axis view, the image plane is parallel to the course of the vessel (needle is "in-plane"). The image shows the course of the vessel across the screen and the shaft and point of the needle as it is advanced. The central venous cannulation was done in in-plane axis.

Treatment:

Procedure: Out of plane Axis