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

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).