ABSTRACT
Frequently used sites for the central venous cannulation include the internal jugular vein, subclavian vein, and femoral vein. The selection of cannulation site is based on the relative risk of complications that are mechanical (pneumothorax, hemothorax, arterial puncture, etc), infectious or thrombotic.(4-6)
internal jugular vein The internal jugular vein (IJV) is the most studied site for US-guided cannulation. Several landmark puncture techniques have been described to accomplish cannulation.(7) The most common one is to insert the needle just lateral to the pulse of common carotid artery (CCA). However, up to a quarter of IJV are not lateral to the CCA.(1) In the US-guided technique, the transducer probe is placed transversely on the neck to obtain a cross sectional image of the IJV and CCA. The probe is then rotated 90 degrees to obtain a longitudinal image of the IJV. After obtaining the anatomical information regarding the position of the IJV relative to CCA and excluding the presence of venous
thrombosis, a needle puncture is performed with or without real time US monitoring. A standard Seldinger technique is used to advance the catheter.
