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      Percutaneous Catheterization of the Internal Jugular Vein for Hemodialysis

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          Abstract

          Objectives

          The present study was aimed at evaluating the clinical experiences in the internal jugular venous catheterization for hemodialysis.

          Methods

          We retrospectively analyzed the data on internal jugular venous catheterization at Chonnam National University Hospital from May 2000 to Februrary 2001.

          Results

          There were 132 uremic patients with a total of 150 attempts of internal jugular cannulation. Overall success rate was 90.9% with average puncture trials of 2.3±2.1. 124 (82.7%) of the catheterization attempts were made on the right side and 26 (17.3%) were made on the left. The catheters were left in place from 2 to 87 days with an average of 19.5±15.3 days per catheter. The dialysis sessions per catheter were from 2 to 58 with an average of 11.3±6.8. The mean blood flow during hemodialysis immediately after catheterization was 213.4±42.2 ml/min. Thirty two (21.3%) patients had early complications. These included carotid artery puncture (11.3%), local bleeding (4.7%), local pain (3.3%), neck hematoma (0.7%) and malposition of the catheter (1.3%). Seventeen (11.3%) patients had late complications. These included fever or infection (11.3%), inadequate blood flow rate (3.3%) and inadvertent withdrawal (2.0%). There was no catheter-related mortality.

          Conclusions

          Our experiences revealed that the internal jugular vein catheterization is relatively safe and efficient for temporary vascular access for hemodialysis.

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          Most cited references22

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          Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula.

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            Ultrasound-assisted cannulation of the internal jugular vein. A prospective comparison to the external landmark-guided technique.

            Central venous access is an essential part of patient management in many clinical settings and is usually achieved with a blinded, external landmark-guided technique. The purpose of this study is to evaluate whether an ultrasound technique can improve on the traditional method. We prospectively evaluated an ultrasound-guided method in 302 patients undergoing internal jugular venous cannulation and compared the results with 302 patients in whom an external landmark-guided technique was used. Ultrasound was used exclusively in an additional 626 patients. Cannulation of the internal jugular vein was achieved in all patients (100%) using ultrasound and in 266 patients (88.1%) using the landmark-guided technique (p < 0.001). The vein was entered on the first attempt in 78% of patients using ultrasound and in 38% using the landmark technique (p < 0.001). Average access time (skin to vein) was 9.8 seconds (2-68 seconds) by the ultrasound approach and 44.5 seconds (2-1,000 seconds) by the landmark approach (p < 0.001). Using ultrasound, puncture of the carotid artery occurred in 1.7% of patients, brachial plexus irritation in 0.4%, and hematoma in 0.2%. In the external landmark group, puncture of the carotid artery occurred in 8.3% of patients (p < 0.001), brachial plexus irritation in 1.7% (p < 0.001), and hematoma in 3.3% (p < 0.001). Ultrasound-guided cannulation of the internal jugular vein significantly improves success rate, decreases access time, and reduces complication rate. These results suggest that this technique may be preferred in complicated cases or when access problems are anticipated.
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              III. NKF-K/DOQI Clinical Practice Guidelines for Vascular Access: update 2000.

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                Author and article information

                Journal
                Korean J Intern Med
                Korean J. Intern. Med
                The Korean Journal of Internal Medicine
                Korean Association of Internal Medicine
                1226-3303
                2005-6648
                December 2001
                : 16
                : 4
                : 242-246
                Affiliations
                [* ]Department of Internal Medicine, Seonam University College of Medicine, Gwangju, Korea
                Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
                Author notes
                Address reprint requests to: Ki-Chul Choi, M.D., Ph.D., Division of Nephrology, Department of Internal Medicine, Chonnam National University Medical School, 8 Hak-dong, Dongku, Gwangju 501-757, Korea
                Article
                kjim-16-4-242-4
                10.3904/kjim.2001.16.4.242
                4578054
                11855153
                ac73cd72-2215-4db9-8c0f-219489392ddb
                Copyright © 2001 The Korean Association of Internal Medicine

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Internal medicine
                internal jugular vein,vascular access,hemodialysis
                Internal medicine
                internal jugular vein, vascular access, hemodialysis

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