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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2017, Number 2

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An Med Asoc Med Hosp ABC 2017; 62 (2)

Ultrasound measurement of the internal jugular vein diameter in the inspiratory pause for assessing central vein access

Loera RA, Urías RVEG, Guadarrama QF, Arce BB, Sandoval RAG, Chacón UEJ, Ortega SJ

Language: Spanish
References: 12
Page: 85-90
PDF size: 213.94 Kb.


ABSTRACT

Background: Placing central venous catheters by different routes, including the jugular vein, is part of the invasive procedures carried out by the medical staff of various specialties; it is done for handling fluids, blood products, amines, invasive pressures, among others. Objective: To identify what parameters are ideal for patients who are intubated at an intensive care unit changing both the positive end-expiratory pressure and the inspiratory pause to achieve the increase in diameter of the jugular vein and, thereby, facilitate the insertion of catheters into it and reduce the complications. Material and methods: Experimental, controlled, randomized, multicenter clinical trial, which included 88 measurements (four per person) in 22 subjects, conducted at the intensive care unit of three hospitals. We included individuals under sedation and ventilatory mode with/without inspiratory pause, with an age range of 25-69 years. We measured the jugular vein without changing the ventilatory parameters. Later, PEEP (0, 5, 10, 15 cmH2O) was modified, with inspiratory pause unchanged. After that, the inspiratory pause (0, 0.5, 1.0, 1.5 seconds) was adjusted, with PEEP 0; there was a five-minute lapse between each change. Results: A significant difference was found when modifying both the inspiratory pause parameter and the positive end-expiratory pressure to achieve an increase in diameter of the jugular vein. Conclusions: By modifying the ventilatory parameters, we obtained a maximum measurement of the internal jugular vein of 1.17 mm that can help to facilitate the insertion of jugular catheters.


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