External Jugular Vein Catheterization Using 'Intra-Atrial Electrocardiogram'.
10.3349/ymj.2009.50.2.222
- Author:
Dilek KARAASLAN
1
;
Ugur ALTINISIK
;
Tulay Tuncer PEKER
;
Esra NAYIR
;
Sadik OZMEN
Author Information
1. Department of Anesthesiology and Reanimation, Suleyman Demirel University School of Medicine, Isparta, Turkey. dilekkaraaslan1@yahoo.com
- Publication Type:Original Article
- Keywords:
Veins, jugular;
catheterization, central venous;
monitoring, electrocardiography
- MeSH:
Catheterization, Central Venous/*methods;
Electrocardiography/*methods;
Female;
Humans;
*Jugular Veins;
Male;
Middle Aged
- From:Yonsei Medical Journal
2009;50(2):222-226
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To investigate the reliability of intra-atrial electrocardiogram (ECG) use for external jugular vein (EJV) catheterization. MATERIALS AND METHODS: Patients undergoing open heart surgery in Suleyman Demirel University Hospital between February and June 2006 were included in the study. Using a sterile Seldinger technique, a triple lumen polyurethane central venous catheter was introduced (Certofix(R) Trio V 720, length 20 cm, 7 French) under intra-atrial ECG guidance. The presence of an increase in P-wave size was recorded. Just after the surgery, a portable chest X-ray was taken. The method was considered to be successful when a change in P-wave could be seen and the catheter was in the superior vena cava, as well as when there was no change in P-wave and the catheter was not in the superior vena cava. RESULTS: In six patients (12%), we were not able to advance the guidewire. In the remaining 44 patients, the catheter was inserted without problem. Eight of these 44 catheters were positioned in the innominate vein, with a malposition ratio of 18%. The success rate of external jugular vein cannulation with intra-atrial ECG was 95%. No complications occured related to the EJV cannulation. CONCLUSION: Considering that it is easily accessed without complication, and the malposition is successfully detected by intra-atrial ECG, EJV is a suitable access for central venous cannulation when internal jugular vein (IJV) is not usable.
