Contralateral Head Rotation on Internal Jugular Vein to Carotid Artery Distance and Overlap Ratio

The Effect of Contralateral Head Rotation on Internal Jugular Vein to Carotid Artery Distance and Overlap Ratio

This study aims to find out the effect of contra lateral head rotation to distance and overlapping of internal jugular vein and carotid artery at cricoid cartilage level by ultrasound guidance on the Malay race in Indonesia

Study Overview

• Status: Completed
• Conditions: Surgery; Central Venous Catheterization
• Intervention / Treatment: Procedure: Triangle of Sedillot identification using ultrasonography

Detailed Description

Approval from Ethical Committee of Faculty of Medicine Universitas Indonesia was acquired prior conducting the study. 34 subjects were enrolled by using consecutive sampling method. Sample size was calculated by using numeric analytic comparative paired formula with repeated measurement. Inclusion criteria were patients with ASA score 1 and 2, aged between 18-60 years old, no anatomical abnormality in neck. Exclusion criteria were patients who were either obese, has history of previous central venous catheter cannulation, and limitation on contralateral head movement. Drop out criteria was abnormalities of anatomical IJV and CA. Basic demographic data, such as sex, age, body weight and height, body mass index were recorded. Patients were positioned in Trendelenburg (15°) position. Identification triangle of Sedillot at cricoid level in right neck with palpation at angle 0°. USG probe was placed upright at the top of triangle of Sedillot at cricoid level. Identification of IJV and CA was shown in transversal view then the IJV to CA distance and overlap ratio was calculated. Contralateral head rotation was done with protractor at angle 30°, 45°, and 60°. The distance and overlap ratio of IJV and CA was calculated in each angle.

• Study Type: Interventional
• Enrollment (Actual): 34
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Indonesia
  • Jakarta, Indonesia, 10430
    • Cipto Mangunkusumo Central National Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 60 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• ASA score 1 and 2
• 18-60 years old
• no anatomical abnormality in neck

Exclusion Criteria:

• obese
• has history of previous central venous catheter cannulation
• limitation on contralateral head movement

Study Plan

How is the study designed?

Design Details

• Primary Purpose: SUPPORTIVE_CARE
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
OTHER: Triangle of Sedillot identification using ultrasonography; USG probe placed upright at the top of triangle of Sedillot at cricoid level	Procedure: Triangle of Sedillot identification using ultrasonography; Contralateral head rotation was done with protractor at angle 30°, 45°, and 60°. The distance and overlap ratio of IJV and CA was calculated in each angle.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
IJV to CA distance at different contralateral rotation angle	IJV to CA distance at different contralateral rotation angle (0°, 30°, 45°, 60°)	2 months
IJV to CA overlap ratio at different contralateral rotation angle	IJV to CA overlap ratio at different contralateral rotation angle (0°, 30°, 45°, 60°)	2 months

Collaborators and Investigators

• Sponsor: Indonesia University

Publications and helpful links

General Publications

• Lieberman JA, Williams KA, Rosenberg AL. Optimal head rotation for internal jugular vein cannulation when relying on external landmarks. Anesth Analg. 2004 Oct;99(4):982-988. doi: 10.1213/01.ANE.0000132908.77111.CA.
• Troianos CA, Hartman GS, Glas KE, Skubas NJ, Eberhardt RT, Walker JD, Reeves ST; Councils on Intraoperative Echocardiography and Vascular Ultrasound of the American Society of Echocardiography. Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2011 Dec;24(12):1291-318. doi: 10.1016/j.echo.2011.09.021. No abstract available.
• Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev. 2015 Jan 9;1(1):CD011447. doi: 10.1002/14651858.CD011447.
• Sibai AN, Loutfi E, Itani M, Baraka A. Ultrasound evaluation of the anatomical characteristics of the internal jugular vein and carotid artery--facilitation of internal jugular vein cannulation. Middle East J Anaesthesiol. 2008 Oct;19(6):1305-20.
• Saitoh T, Satoh H, Kumazawa A, Nobuhara M, Machii M, Tanaka T, Shiraki K, Saotome M, Urushida T, Katoh H, Hayashi H. Ultrasound analysis of the relationship between right internal jugular vein and common carotid artery in the left head-rotation and head-flexion position. Heart Vessels. 2013 Sep;28(5):620-5. doi: 10.1007/s00380-012-0283-0. Epub 2012 Sep 12.
• Troianos CA, Kuwik RJ, Pasqual JR, Lim AJ, Odasso DP. Internal jugular vein and carotid artery anatomic relation as determined by ultrasonography. Anesthesiology. 1996 Jul;85(1):43-8. doi: 10.1097/00000542-199607000-00007.
• Miki I, Murata S, Nakazawa K, Onozawa S, Mine T, Ueda T, Yamaguchi H, Yasui D, Takeda M, Kumita S. Anatomical relationship between the common carotid artery and the internal jugular vein during head rotation. Ultrasound. 2014 May;22(2):99-103. doi: 10.1177/1742271X14524571. Epub 2014 Feb 25.
• DeAngelis V, Denny J, Chyu D, Jan T, Lemaire A, Chiricolo A, Solina A. The Optimal Angle of Head Rotation for Internal Jugular Cannulation as Determined by Ultrasound Evaluation. J Cardiothorac Vasc Anesth. 2015 Oct;29(5):1257-60. doi: 10.1053/j.jvca.2015.02.007. Epub 2015 Feb 9.
• Shoja MM, Ardalan MR, Tubbs RS, Loukas M, Vahedinia S, Jabbary R, Jalilvand M, Shakeri A. The relationship between the internal jugular vein and common carotid artery in the carotid sheath: the effects of age, gender and side. Ann Anat. 2008;190(4):339-43. doi: 10.1016/j.aanat.2008.04.002. Epub 2008 May 27.

Study record dates

Study Major Dates

• Study Start (ACTUAL): December 1, 2018
• Primary Completion (ACTUAL): January 30, 2019
• Study Completion (ACTUAL): February 28, 2019

Study Registration Dates

• First Submitted: November 7, 2018
• First Submitted That Met QC Criteria: November 13, 2018
• First Posted (ACTUAL): November 15, 2018

Study Record Updates

• Last Update Posted (ACTUAL): January 2, 2020
• Last Update Submitted That Met QC Criteria: December 30, 2019
• Last Verified: December 1, 2019

More Information

Terms related to this study

• Keywords: ultrasonography; central venous catheterization; jugular veins; carotid arteries; Malay race
• Other Study ID Numbers: IndonesiaUAnes025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No