Debate between short and long axis for ultrasound-guided internal jugular vein cannulation. Prospective trial aims to settle the issue. Two-person technique for stability. Study compares outcomes and complications. Practical considerations for each approach discussed. Potential benefits of long axis approach.
Long axis ultrasound view showed better first attempt success and lower complication rates.
Study results suggest no significant difference in procedural time between short and long axis approaches for IJ cannulation.
Deep dives
Vascular Access Preference
The podcast episode delves into the importance of vascular access in ultrasound, highlighting the speaker's preference for ultrasound-guided peripheral IVs and central lines. The focus of the episode is on a study comparing short versus long access ultrasound-guided approaches for internal jugular vein cannulations. The speaker expresses curiosity about unexpected results favoring the long access view over the short access view, leading to an in-depth analysis of the study's intricacies and methodology.
Study Methodology and Results
The podcast discusses the methodology and results of the study, where anesthesiology residents with minimal training performed the procedures under supervision. The study aimed to determine the safety and efficiency of the short versus long axis approach, measuring procedural time, number of needle sticks, first attempt success, and complication rates. Interestingly, the study outcomes revealed no statistical difference in procedural time between the approaches, but showed superior results in first attempt success and complication rates for the long axis technique.
Evaluation and Limitations
The episode highlights limitations and potential biases in the study, suggesting a tendency towards a favorable outcome for the long axis approach. The speakers question the relevance of the two-person operator technique used in the study, emphasizing the importance of dynamic guidance for accurate needle placement. They advise caution in interpreting the study's findings due to discrepancies in training methods and ultrasound guidance approaches, advocating for a more balanced and practical approach to vascular access techniques.
It is an age-old question - short or long axis? Using ultrasound guidance for internal jugular vein cannulation is now fairly standard. There are a lot of opinions regarding if it is best to visualize the target in short axis (cross section) or long axis (parallel to the vein). There are certainly benefits to both. This episode features a prospective randomized trial that attempts to put an end to this debate.
https://www.ultrasoundgel.org/85
https://www.ncbi.nlm.nih.gov/pubmed/31230925
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode