Relationship between the Right Internal Jugular Vein and Carotid Artery at Ipsilateral Head Rotation

Autor: Ali Sami Kivrak, Seza Apiliogullari, Seda Ozbek, Ali Ozgul Saltali, Inci Kara
Rok vydání: 2013
Předmět:
Zdroj: Renal Failure. 35:761-765
ISSN: 1525-6049
0886-022X
Popis: Ultrasound-guided right internal jugular vein catheterization (RIJV) should be the first choice to decrease the catheter-related complications in high-risk hemodialysis patients. For this procedure, clinicians should identify the optimum positions of the RIJV, including its lower overlap with the carotid artery (CA) and high cross-sectional area of the vein. The aim of this prospective randomized study to evaluate the effects of mild ipsilateral head rotation combined with Trendelenburg position on RIJV cross-sectional area and its relation to the CA in adult patients. Forty ASA I-II patients who were undergoing elective surgery were enrolled for this study. The subjects were asked to remain supine in the 15-20° Trendelenburg position. Two-dimensional ultrasound was then used to measure the degree of overlap between the RIJV and CA, the cross-sectional area of the RIJV. These measurements were compared between head rotation to the30° left,30° left, neutral, and30° right positions. When the head was in the30° left position, overlap was seen in 38 of 40 patients (95%). As the head was rotated from30° left to30° right, the CA-RIJV overlap (from 95% to 57.5%), and the cross-sectional area (from 14.2 mm to 8.7 mm) significantly decreased. In conclusion, when the head was turned to30° right, the CA-RIJV overlap significantly decreased, and the cross-sectional area also decreased. When clinicians determine the optimal head position before RIJV cannulation, it is important to consider the advantages and disadvantages of the different head positions from30° left to30° right.
Databáze: OpenAIRE
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