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Comparison of Short-Axis and Long-Axis Internal Jugular Vein Cannulation for First-Pass Success

8. juli 2026 opdateret af: Ahmad, University of Health Sciences Lahore

Comparison Between Short Axis and Long Axis For Cannulation Of Internal Jugular Vein in Terms Of First Pass Success

To compare the frequency of first pass success by short axis versus long axis for cannulation of internal jugular vein.

Studieoversigt

Detaljeret beskrivelse

This randomized controlled trial aims to compare the effectiveness of short-axis and long-axis ultrasound-guided approaches for cannulation of the internal jugular vein (IJV) in terms of first-pass success. Central venous catheterization is a commonly performed procedure for invasive monitoring and administration of medications and fluids. Ultrasound guidance has improved the safety and success of IJV cannulation compared with traditional landmark-based techniques; however, uncertainty remains regarding the optimal ultrasound imaging approach.

A total of 60 eligible patients undergoing IJV cannulation will be enrolled and randomly allocated into two equal groups. Participants in Group A will undergo ultrasound-guided IJV cannulation using the short-axis approach, while participants in Group B will undergo cannulation using the long-axis approach. All procedures will be performed by the researcher under direct supervision using standardized ultrasound-guided techniques.

The primary objective is to compare the frequency of first-pass success between the two approaches. First-pass success is defined as successful IJV cannulation with a single skin puncture and without needle redirection. Baseline demographic and clinical characteristics will be recorded before the procedure. The findings of this study may help identify the preferred ultrasound-guided technique for maximizing first-pass success during IJV cannulation and potentially reducing procedure-related complications associated with multiple cannulation attempts.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

10

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • National Hospital and Medical Center
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Age 25-70 years.
  • Either male or female gender.
  • Undergoing cannulation of IJV.

Exclusion Criteria:

  • Patients who will be on hemodialysis therapy through double lumen catheter in IJV, assessed by reviewing previous medical records.
  • Patients who will have history of previous insertion of IJV line, assessed by reviewing previous medical records.
  • Patients with history of neck surgery, assessed by reviewing previous medical records.
  • Uncooperative patient.
  • Platelet count < 50,000/mm3.
  • International normalized ration 3 times upper normal limit (1.1).

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Group A (Short-Axis Approach)
In this approach, IJV will be visualized by placing the transducer in a transverse orientation on the patient neck at the level of the cricoid cartilage. The needle will be inserted at 60° to the vertical and will be advanced toward the vein employing gentle aspiration on the attached syringe. Entry to the vein will be confirmed by visualizing indentation of the anterior wall of the vein followed by blood in the syringe and by visualizing the tip of the needle inside the vein. Guide wire will be passed followed by dilator insertion and finally central vein line.
Internal jugular vein cannulation performed under ultrasound guidance using the short-axis approach. The transducer is placed in a transverse orientation at the level of the cricoid cartilage, allowing visualization of the internal jugular vein and carotid artery during needle insertion.
Aktiv komparator: Group B (Long-Axis Approach)
In this approach, the probe will be centered on the IJV and rotated through 90° in a clockwise direction resulting in long axis image of the vein. The needle insertion point will be directly beneath the most proximal end of the ultrasound probe. The needle will be inserted at 30° to the vertical and will be advanced toward the vein employing gentle aspiration. Entry to the vein will be confirmed by visualizing needle entry into the vein followed by aspiration of blood in the syringe. Guide wire will be inserted followed by dilator insertion and finally central vein line.
Internal jugular vein cannulation performed under ultrasound guidance using the long-axis approach. The transducer is rotated to obtain a longitudinal view of the internal jugular vein, allowing continuous visualization of the needle during vessel cannulation.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
First-Pass Success Rate of Ultrasound-Guided Internal Jugular Vein Cannulation
Tidsramme: Assessed during the cannulation procedure (within 5 minutes of initiation of cannulation).
First-pass success rate of ultrasound-guided internal jugular vein cannulation, defined as successful venous cannulation with a single skin puncture and needle pass.
Assessed during the cannulation procedure (within 5 minutes of initiation of cannulation).

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Total Cannulation Success Rate
Tidsramme: Assessed during the procedure (within 15 minutes).
Total cannulation success rate, defined as successful placement of the internal jugular venous catheter.
Assessed during the procedure (within 15 minutes).
Number of Needle Passes Required for Successful Cannulation
Tidsramme: Recorded during the procedure.
Total number of needle insertion attempts required to achieve successful ultrasound-guided internal jugular vein cannulation.
Recorded during the procedure.
Incidence of Hematoma Formation at the Cannulation Site
Tidsramme: Assessed immediately after the procedure and within 24 hours.
Occurrence of hematoma at the internal jugular vein cannulation site following ultrasound-guided catheter insertion.
Assessed immediately after the procedure and within 24 hours.
Incidence of Posterior Vessel Wall Puncture
Tidsramme: Assessed during the procedure.
Occurrence of unintended puncture of the posterior wall of the internal jugular vein during ultrasound-guided cannulation.
Assessed during the procedure.
Incidence of Pneumothorax Following Cannulation
Tidsramme: Assessed within 24 hours following cannulation.
Occurrence of pneumothorax associated with ultrasound-guided internal jugular vein cannulation.
Assessed within 24 hours following cannulation.
Overall Procedure-Related Complications
Tidsramme: Assessed during the procedure and up to 24 hours after cannulation.
Frequency of procedure-related adverse events, including hematoma, posterior vessel wall puncture, pneumothorax, or other complications occurring during or after ultrasound-guided internal jugular vein cannulation.
Assessed during the procedure and up to 24 hours after cannulation.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Studiestol: Shahida Khawaja, MBBS, FCPS, National Hospital and Medical Center

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. oktober 2026

Primær færdiggørelse (Anslået)

1. april 2027

Studieafslutning (Anslået)

1. april 2027

Datoer for studieregistrering

Først indsendt

25. juni 2026

Først indsendt, der opfyldte QC-kriterier

2. juli 2026

Først opslået (Faktiske)

9. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. juli 2026

Sidst verificeret

1. juli 2026

Mere information

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