METHODS OF INCREASING THE SAFETY OF CATHETERIZATION OF THE INTERNAL JUGULAR VEIN DURING HYPOVOLEMIA
https://doi.org/10.24060/2076-3093-2017-7-1-19-24
Abstract
The aim of research is to study the possibility to increase the security of the internal jugular vein catheterization through the choice of access to puncture it, based on the values of its size.
Materials and methods. Ultrasound scanning of IJV with the measurement of anteriorposterior and medial-lateral size was conducted among 20 healthy adult volunteers (control group) and 16 adult patients (observation group) who were treated in the Anesthesiology and Resuscitation Department.
Results. It was found that the test values in the control group the anterior-posterior and medial-lateral vein is larger than 7 mm in both inhalation and exhalation. Under the conditions of hypovolemia (observation group) anterior-posterior size IJV inspiratory became less than 7 mm, and the medial-lateral vein size, despite its decrease retained value of more than 7 mm in most subjects. Among healthy volunteers it was found that the rotation of the ultrasonic sensor 45 ° is accompanied by increase in the average values of the medial-lateral vein size by more than 50%. This maneuver may be useful for patients whose value of the medial-lateral vein size inspiratory was less than 7 mm.
Conclusion. The choice of central or lateral approach to puncture the internal jugular vein may be based on the actual values of the anterior-posterior and medial-lateral dimensions of it. The usage of lateral access for catheterization of internal jugular vein under ultrasound imaging can be more secure for patients with hypovolemia. The maneuver of ultrasonic sensor for 45° clockwise can be used to increase the size of the medial-lateral rotation.
About the Authors
A. V. Shchegolev
Kirov Military Medical Academy
Russian Federation
Russian Federation
Doctor of Medical Sciences, Chair of Anesthesiology and Intensive Care Department,
the chief Anesthesia and Intensive Care Physician of the Ministry of Defense,
Saint-Petersburg
K. G. Gurevich
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
Russian Federation
Russian Federation
Doctor of Medical Sciences, Chair of UNESCO “Healthy way of life is the key to successful development” Department,
Moscow
A. L. Urakov
Izhevsk State Medical Academy
Russian Federation
Russian Federation
Doctor of Medical Sciences, Chair of the General and Clinical Pharmacology Department,
Izhevsk
A. A. Kasatkin
Izhevsk State Medical Academy
Russian Federation
Russian Federation
Candidate of Medical Sciences, Research Assistant of the General and Clinical Pharmacology Department,
Izhevsk
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Review
For citations:
Shchegolev A.V., Gurevich K.G., Urakov A.L., Kasatkin A.A. METHODS OF INCREASING THE SAFETY OF CATHETERIZATION OF THE INTERNAL JUGULAR VEIN DURING HYPOVOLEMIA. Creative surgery and oncology. 2017;7(1):19-24. (In Russ.) https://doi.org/10.24060/2076-3093-2017-7-1-19-24
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