Ultrasound Guidance vs. Landmark Technique for Catheter Malposition in IJV Catheterization

July 8, 2026 updated by: Fikret Salık, Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

The Effect of Ultrasound Guidance Versus Landmark Technique on Catheter Malposition in Internal Jugular Vein Catheterization

Central venous catheterization (CVC) via the internal jugular vein (IJV) is a fundamental procedure in anesthesia and intensive care for hemodynamic monitoring, fluid resuscitation, and vasoactive drug administration. While modern clinical guidelines strongly advocate for ultrasound (USG) guidance, the traditional anatomical landmark technique remains widely utilized due to equipment availability or clinician habits. Proper positioning of the catheter tip is critical to prevent severe long-term complications; however, comparative data regarding catheter tip malposition between these two routine techniques-especially when confirmed by postprocedural bedside chest X-ray-require further prospective evaluation. Objective:

The primary objective of this prospective observational study is to compare ultrasound-guided versus landmark techniques for internal jugular vein catheterization with respect to catheter tip malposition, as determined by postprocedural bedside chest X-ray. Secondary objectives include the evaluation of the number of needle redirections, first-attempt success rate, total procedure time, and the incidence of mechanical complications (such as accidental arterial puncture or hematoma formation)

Study Overview

Status

Status

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Not yet recruiting

Conditions

Conditions

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Intervention / Treatment

Intervention / Treatment

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Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
204

Contacts and Locations

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Study Contact

Study Contact

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Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

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Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Adult and elderly patients (18-75 years) undergoing elective or scheduled surgery in the general operating room unit of Dicle University Faculty of Medicine Hospital who require central venous catheterization via the internal jugular vein as part of routine perioperative care. The catheterization technique (ultrasound-guided or landmark) reflects the routine practice of the performing physician; no technique is assigned by the study for research purposes.

Description

Inclusion Criteria:

  • Patients aged 18-75 undergoing surgery requiring central venous (internal jugular) catheterization

Exclusion Criteria:

  • Refusal to participate
  • age <18 or >75
  • emergency surgery
  • coagulopathy
  • infection, prior surgery, or prior cannulation at the insertion site
  • allergy to ultrasound gel

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Ultrasound-guided group
IJV catheterization performed under real-time ultrasound guidance
Procedure: Ultrasound-Guided Technique
Internal jugular vein catheterization performed with real-time ultrasound visualization of the vein to guide needle insertion.
Landmark technique group
IJV catheterization performed via anatomical landmark technique
Procedure: Landmark Technique
Internal jugular vein catheterization performed using external anatomical landmarks without real-time ultrasound guidance.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
Incidence of catheter tip malposition
Time Frame: Assessed on postoperative bedside chest X-ray, immediately following the procedure
Assessed on postoperative bedside chest X-ray, immediately following the procedure

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Incidence of Procedural Mechanical Complications
Time Frame: During the procedure and up to 24 hours post-operatively.
The occurrence and rate of immediate mechanical complications directly related to the intervention, specifically tracking accidental carotid arterial punctures and hematoma formations.
During the procedure and up to 24 hours post-operatively.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

Publications and helpful links

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General Publications

Study record dates

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Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 15, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 15, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 15, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 14, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 14, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 321/2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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