Right internal jugular vein cross-sectional area: Is there an optimal level for cannulation?

Oscar Aljure, Catalina M. Castillo-Pedraza, Greta Mitzova-Vladinov, Edward Maratea

Research output: Contribution to journalArticle

Abstract

Background Perioperatively, the preferred site for central venous access by anesthesia providers is the right internal jugular vein (RIJV). Maneuvers such as Trendelenburg position and positive end-expiratory pressure are commonly performed to increase the size of the RIJV and increase the success rate of cannulation. Methods We evaluated the size of RIJV at various anatomic levels in the neck to assess the most advantageous level for cannulation with patients in a flat, supine position without use of Trendelenburg. In this study 18 healthy subjects were placed in a flat, supine position for measurements of the cross-sectional area (CSA) of the RIJV using vascular ultrasound. Three measurements were obtained at each of the 5 anatomic levels of the neck. The first baseline measurement was taken at the level of cricoid cartilage (0 cm), followed by measurements at 4 other levels: cephalad to the cricoid cartilage at +1 and +2 cm, and caudad to the cricoid cartilage at -1 and -2 cm. The measurements of the CSA in centimeters2 were electronically calculated after manual anatomic outlining of the vein. Factors that may influence the RIJV size, including age, gender, and body surface area, were included in the data analysis. Results The average CSA of the RIJV at the 5 levels measured (from +2 to -2 cm) were 0.91, 0.97, 1.06, 1.10, and 1.14 cm2, respectively. The CSA of the RIJV was significantly larger at every 1-cm interval from the most cephalad level at +2 cm to the -2 cm most caudad level, except for the 0 to the -1 cm interval. Statistically significant difference in the CSA (P

Original languageEnglish (US)
Pages (from-to)22-25
Number of pages4
JournalJAVA - Journal of the Association for Vascular Access
Volume20
Issue number1
DOIs
StatePublished - Mar 1 2015

Keywords

  • central venous cannulation
  • jugular vein
  • ultrasound guidance

ASJC Scopus subject areas

  • Medicine (miscellaneous)

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