The "medial-oblique" approach to ultrasound-guided central venous cannulation - Maximize the view, minimize the risk

Ralph Dilisio, Alexander J.C. Mittnacht

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Carotid puncture and insertion of a large-bore catheter into the carotid artery is a feared complication associated with internal jugular vein (IJV) cannulation. The use of ultrasound with real-time imaging of the neck vessels during needle insertion has the potential to decrease the incidence of serious complications associated with central venous access. The authors describe a new technique for ultrasound-guided IJV cannulation. The suggested "medial-oblique" approach allows for optimal imaging of the IJV and the carotid artery side by side and following the needle throughout the insertion from skin to vessel penetration in a medial-cephalad to lateral-caudad direction. This technique combines the advantages of the short-axis and long-axis approaches and minimizes the risk of carotid puncture from a medial-to-lateral needle direction.

Original languageEnglish
Pages (from-to)982-984
Number of pages3
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume26
Issue number6
DOIs
StatePublished - Dec 2012

Keywords

  • central venous
  • critical care medicine
  • ultrasound

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