Comparison of the success rate and complications in internal jugular vein cannulation in the first attempt between two ultrasound-guided and 22G needle-guided methods in university hospitals in Zahedan during 2023–2024
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: BACKGROUND: Internal jugular vein (IJV) cannulation is required for various indications, including hydration, administration of antibiotics or chemotherapy, and hemodialysis. This procedure is traditionally performed using a needle method, in which the physician performs cannulation using anatomical landmarks with the guidance of a 22G needle inserted before the main cannula to find the vein successfully. However, this method may be unsuccessful and associated with complications; therefore, ultrasound (US)-guided catheter placement is recommended, which is not available in all centers. Based on our clinical experience, we hypothesized that the needle-guided method may also have success and complication rates similar to the US method when performed meticulously. Therefore, we compared the success and complication rates of catheter placement in the IJV between two methods: US and needle-guided and studied the related factors. METHODS: Patients requiring IJV catheter placement, who were referred to educational hospitals of the Zahedan University 2023-2024, were randomly divided into two groups: in one group, a catheter was placed under US guidance ( N = 31) and in the other group, under needle guidance ( N = 31). The success of the operation in the first attempt and complication rate were reported, along with their association with demographic and clinical factors, analyzed using SPSS and considered significant at P -values <0.05. RESULTS: A total of 62 patients were studied (61.3% male with a mean age of 50.79 ± 19.75 years). The patients in the two groups (31 in each group) did not differ in terms of gender distribution, mean age, height, weight, and body mass index; nor in terms of indication, duration of operation, neck type, and insertion side ( P > 0.05). However, the first-attempt success rate was significantly higher in the US-guided group (25 vs. 11 patients, P < 0.001). All four patients whose operation time was more than 5 minutes failed ( P < 0.001). Logistic regression showed that the greater height and weight, as well as the hard neck type, decreased the chance of success (OR = -4.2; P = 0.031). CONCLUSION: The higher first-attempt success rate of the US-guided method for catheter insertion in the IJV, compared to needle-guided, suggests this method as the preferred method, while we did not observe a difference in the duration of catheterization and the complication rates. These findings suggest the needle-guided method is an appropriate method, as well, when performed by an experienced surgeon under standard conditions. Further studies with a larger sample size are required for definite conclusions.
Source: International Journal of Surgery
Institution: Zahedan University of Medical Sciences
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,450
OpenAlex ID: W4416673751