Abdo A, Castellanos R, Benítez Y, Suarez-López J, Machado RE, Gutiérrez JA, Castellanos A, González D, Leal G, Gómez F

Language: Spanish
References: 12
Page: 28-33
PDF size: 265.16 Kb.

ABSTRACT

Introduction: multiparametric neuromonitoring represents an essential pillar in the performance of neurocritical patients. Cerebral metabolism monitoring through the blood obtained from the jugular bulb is one of the most used. In a traditional way, the catheter has been placed in the internal jugular vein (IJV) retrograde for the anatomical referents technique. The main complications are arterial puncture, hematoma, pneumothorax and nerve injury.
Development: On this communication, IJV retrograde catheterization technique is presented using real-time ultrasound. A linear 8-MHz transducer was placed perpendicular to the skin in the short-axis plane between the two bundles of the sternocleidomastoid muscle at the level of the cricoid cartilage, avoiding the IJV compression. After confirming the depth and the IJV - carotid artery ratio, the skin was punctured at a 60 degree angle in the cephalic direction. The successful channeling of the IJV was confirmed by both the displacements of the needle tip into IJV anterior wall or acoustic shadow in real time images and aspiration by syringe free of blood. The tip was confirmed by a lateral cervical radiograph.
Conclusions: incorporation of ultrasonography for IJV retrograde catheterization allows reducing the mechanical complications and increases the success percent at the first attempt of puncture as well as it helps to select the side which will be monitored.

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