An outcome study on complications using routine ultrasound assistance for internal jugular vein cannulation

Background: Ultrasound guidance for central venous cannulation is advised by recent guidelines, but is not being applied in everyday practice. The purpose of this study was to determine the reduction in complications when applying an ultrasound locating device for internal jugular vein catheterization. Methods: An observational study was conducted from November 2004 to October 2005 in a tertiary neurosurgical hospital on 300 patients undergoing internal jugular vein cannulation using an ultrasound technique. Patients were not randomized and operators were trained using theoretical and practical courses. Prior to the study, the investigators, who were consultant anaesthesiologists, had to perform at least 20 successful supervised cannulations. Results: Cannulation was successful in all cases. The incidence of arterial puncture was 2.7%, and multiple venous punctures represented the main minor complication (14%). Bivariate analysis of the overall complications revealed no significant correlation with age group, American Society of Anesthesiologists' (ASA) classification, body mass index, or position and diameter of the vein. Conclusions: Ultrasound cannulation of the internal jugular vein minimized complications. These could be avoided when new ultrasound probes and specific needles are introduced.