Internal Jugular Vein Cannulation: A Comparative Study of Two Techniques-Anatomical Landmark and Ultrasound Real Time ? A Prospective Randomized Control Study

Background and Objectives Central venous catheterization plays an important role in patient care in major operative procedures and in intensive care units. The objectives of this study were to evaluate and compare the number of attempts, Vascular access time and complications of cannulating the Internal Jugular vein (IJV) by anatomical landmark and Real time ultrasound. Methodology A total of 100 patients were taken and randomly assigned into two groups of 50 patients each. IJV was cannulated (Seldinger technique) by anatomical land mark method in group 1 and by real time ultrasound method in group 2. Following parameters were observed Age, Sex, Height and Weight, Neck Circumference, Number of Attempts, Vascular access Time and Complications. Results The demographic data of the patients didnt show statistical significance between the two groups. The mean standard deviation of neck circumference (cms) in anatomical landmark group was 40.082.80, and real time ultrasound was 41.082.80 with p value of 0.18, not significant in this study. The mean standard deviation of Body mass index in anatomical landmark group was 24.12.06, and real time ultrasound was 25.063.42 with p value of 0.09 not significant in this study. The mean standard deviation of Vascular access time (seconds) in anatomical landmark group was 340.34160.89 and real time ultrasound was 160.7870.01 with p value less than 0.001 which was statistically significant. In Real time ultrasound group the internal jugular vein was cannulated in first attempt in 46 patients, where as in anatomical landmark only 28 patients with p value less than 0.02 which was statistically significant. The incidence of complication was 6 %in anatomical landmark group and nil in real time ultrasound group Conclusion The ultrasound real time is more beneficial in placing internal jugular vein cannulation compared with traditional anatomical landmark technique with higher success rates and decreased number of complications and increases the safety and comfort of the patients.