Comparison of the Right and Left Internal Jugular Vein Using Ultrasound Clinical Trial
Official title:
Comparison of the Diameter, Cross-sectional Area and Position of the Left and Right Internal Jugular Vein in Adults Using Ultrasound
The purpose of this study is to determine whether there is a difference between the
diameter, and the cross-sectional area of the right internal in left internal jugular vein
in preoperative, mechanically ventilated patients.
Secondary the relationship between the internal jugular vein to the common carotid artery
will be examined.
Placement of a central venous catheter (CVC) for surgery is used for hemodynamic monitoring
and venous access. Most often the right internal jugular vein (RIJV) is used. The RIJV is
preferred over the left-sided internal jugular vein (LIJV) because cannulation of the LIJV
is more difficult and associated with a higher complication rate(1). A possible explanation
for the higher complication rate can be explained by the difference in diameter between the
RIJV and the LIJV. It has been demonstrated that large vessels are easier to catheterize
than small ones.
Data suggest that the internal jugular veins are most often asymmetric but data are limited.
Until now, there is one small prospective study in which 80 ICU patients where examined (30
patients were mechanically ventilated) which showed an asymmetry in 62,5% and a dominant
RIJV in 68% and a smaller study performed by Lobato and colleagues in which 50 healthy
patients were examined. They measured the cross-sectional areas of the internal jugular
veins. They showed that in 80% the RIJV was greater than the LIJV. Two CT studies has been
done so far. In 2009 Tartière and colleagues carried out an observational study in 190
patients. All patients were in the supine position, neutral head position an spontaneous
breathing. During the CT patients were asked to hold there breath. The study showed that the
diameter and cross-sectional area of the RIJV were significantly greater than those of the
LIJV. A smaller retrospective CT-study (88 patients) performed by Lim et al in 2006 showed a
larger RIJV in 79,5% compared to the LIJV.
Until now, there are no data known about the difference between the RIJV and LIJV in
preoperative mechanical ventilated patients when ultrasound is used.
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Observational Model: Case-Only, Time Perspective: Cross-Sectional