Completed

NCT Number: NCT02185664

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

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.

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Key information

Conditions

Adult Cardiac Surgical Patients

Age range

15 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Department of Anesthesia and Intensive Care, Govind Ballabh Pant Hospital

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

About this study

Use of real time ultrasound has recently been recommended as the standard of care for insertion of central venous catheters. However, its usage is limited by various factors which include availability, space constraints and perceived lack of need according to surveys including cardiovascular anesthesiologists. We will conduct a prospective randomized controlled trial to compare the conventional landmark technique with the static ultrasound (US) technique that utilized the transthoracic echocardiography (TTE) ultrasound probe which is supplied along with the transesophageal echocardiography machines for internal jugular vein cannulation in adult cardiac surgical patients.

After ethical committee approval and patient consent, adult patients scheduled for elective cardiac surgery will be randomized to undergo internal jugular vein cannulation by either of the two methods: standard landmark technique (group A: control group), static US technique using the TTE probe (group B: ultrasound group). The success rate, number of attempts, total cannulation time and complication rate in the two groups will be compared.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

adult patients scheduled for elective cardiac surgery

Exclusion criteria

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)

Treatment and study plan

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.

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.

Primary outcomes

success

Time frame: during internal jugular venous cannulation

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

Secondary outcomes

number of attempts by finder/locator needle

Time frame: at the time of internal jugular vein cannulation

The total number of attempts taken to locate the internal jugular vein using the locator/finder needle were measured.
total number of attempts by puncture needle

Time frame: at the time of internal jugular vein cannulation

The total number of attempts taken by the puncture needle to enter the internal jugular vein were measured.
First attempt sucess

Time frame: at the time of internal jugular vein cannulation

First attempt success was defined as location of the IJV by finder needle in the first attempt.
Central venous cannulation time

Time frame: at the time of internal jugular venous cannulation

Time to central venous cannulation (CVC) was defined as the time taken from the insertion of finder needle till de-airing and flushing of all the three ports of the triple lumen catheter.
ultrasound time

Time frame: at the time of internal jugular vein cannulation

The duration of ultrasound was defined as the time between the placement of the probe on neck till the marking of the course of the vein on the skin.
total cannulation time

Time frame: at the time of internal jugular vein cannulation

control group: total cannulation time= central venous cannulation time ultrasound group: total cannulation time= central venous cannulation time+ ultrasound time
complication rate

Time frame: at the time of central venous cannulation

The complication rate was calculated as a percentage of the total number of complications with respect to the sample size

Sponsors and collaborators

Lead sponsor

Govind Ballabh Pant Hospital

Other Gov

Registry information

Official study title

Comparison of the Landmark Technique and the Static Ultrasound Guided Technique for Internal Jugular Vein Cannulation in Adult Cardiac Surgical Patients.

Important dates

Study start: 2011
Primary completion: 2012
Study completion: 2012
First posted: Jul 9, 2014
Registry last updated: Jul 15, 2014

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.