Use of Static Ultrasound Guidance for Internal Jugular Vein Cannulation in Adult Cardiac Surgical Patients

NCT02185664 | Completed DMC

• 1 other identifier: F.2/IEC/MAMC/11/No.96
• Study Type: interventional
• Target: 201
• Locations: 1 country
• Sites: 1

Brief Summary

Cannulation of the internal jugular vein (IJV) for central venous access is a standard practice in cardiac surgery. In this study, the authors tested the hypothesis that using an ultrasound (US) scanner would increase the success of IJV cannulation and decrease the incidence of complications in adult cardiac surgical patients. The study will include adult cardiac surgical patients, randomized into two groups (control vs. US). In the control group, IJV cannulation will be performed by the conventional landmark technique using Seldinger method. In the US group, the course of the IJV will be marked before cannulation using a 2 - 4 MHz transthoracic echocardiography probe. The success rate, number of attempts, cannulation time and complication rate will be compared for the two groups.

Conditions

Adult Cardiac Surgical Patients

Keywords

internal jugular vein; landmark; ultrasound; static; cardiac surgery

Outcome Measures

Primary Outcomes (1)

• success

  Success was defined as location of the IJV by the finder needle within five attempts.

  during internal jugular venous cannulation

Secondary Outcomes (7)

• number of attempts by finder/locator needle

  at the time of internal jugular vein cannulation

• total number of attempts by puncture needle

  at the time of internal jugular vein cannulation

• First attempt sucess

  at the time of internal jugular vein cannulation

• Central venous cannulation time

  at the time of internal jugular venous cannulation

• ultrasound time

  at the time of internal jugular vein cannulation

Study Arms (2)

Landmark technique

ACTIVE COMPARATOR

The landmark technique is the standard technique used for internal jugular vein cannulation.

Procedure: landmark technique

Static Ultrasound technique

EXPERIMENTAL

Static ultrasound technique was used to assist internal jugular vein cannulation.

Device: Static Ultrasound technique

Interventions

landmark technique PROCEDURE

The apex of the imaginary triangle formed between the two heads of sternocleidomastoid and clavicle was used as the point of needle entry, just lateral to the pulsation of the internal carotid artery and directed towards the ipsilateral nipple at an angle of 45 degrees.

Landmark technique

Static Ultrasound technique DEVICE

Static ultrasound guided internal jugular vein cannulation was performed by using the transthoracic echocardiography probe supplied with the transesophageal echocardiography machine in the cardiothoracic surgery operation theatre. The internal jugular vein was located and marked using this method prior to puncture.

Static Ultrasound technique

Eligibility Criteria

• Age: 15 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• adult patients scheduled for elective cardiac surgery

You may not qualify if:

• patients undergoing bidirectional Glenn shunt, Fontan surgery or emergency surgery
• local site infection
• presence of coagulopathy
• anatomical deformity of neck(burns, neck swelling, surgical scar)

Sponsors & Collaborators

• Govind Ballabh Pant Hospital: lead

Study Sites (1)

Department of Anesthesia and Intensive Care, Govind Ballabh Pant Hospital

New Delhi, National Capital Territory of Delhi, 110002, India

Location

Related Publications (3)

• Espinet A, Dunning J. Does ultrasound-guided central line insertion reduce complications and time to placement in elective patients undergoing cardiac surgery. Interact Cardiovasc Thorac Surg. 2004 Sep;3(3):523-7. doi: 10.1016/j.icvts.2004.05.006.

  PMID: 17670301 BACKGROUND

• Bailey PL, Glance LG, Eaton MP, Parshall B, McIntosh S. A survey of the use of ultrasound during central venous catheterization. Anesth Analg. 2007 Mar;104(3):491-7. doi: 10.1213/01.ane.0000255289.78333.c2.

  PMID: 17312193 BACKGROUND

• Hind D, Calvert N, McWilliams R, Davidson A, Paisley S, Beverley C, Thomas S. Ultrasonic locating devices for central venous cannulation: meta-analysis. BMJ. 2003 Aug 16;327(7411):361. doi: 10.1136/bmj.327.7411.361.

  PMID: 12919984 RESULT

Study Officials

• Deepak Tempe, MD

  Govind Ballabh pant Hospital and Maulana azad Medical College, New Delhi, India

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: July 4, 2014
• First Posted: July 9, 2014
• Study Start: April 1, 2011
• Primary Completion: April 1, 2012
• Study Completion: April 1, 2012
• Last Updated: July 15, 2014

Record last verified: 2014-07

Locations

IN (1)