Short Axis In-Plane Ultrasound-Guided Technique for Internal Jugular Vein Cannulation

J Emerg Med. 2023 Apr;64(4):488-490. doi: 10.1016/j.jemermed.2023.02.017. Epub 2023 Mar 21.

Abstract

Background: Real-time ultrasound (US)-guided venipuncture has become the standard of care due to its reduced complications and higher success rate. There are various techniques for US-guided cannulation of the internal jugular vein (IJV); the transversal and longitudinal views are the most widely used. There is a less commonly used technique that combines the benefits of both methods.

Discussion: Two main techniques for central line US-guided cannulation of the IJV are based on the location of the probe relative to the vessel and are known as the transversal view and the longitudinal view. The transversal view may make it difficult to identify the tip of the needle as it enters the vein, and the longitudinal view may not allow for visualization of surrounding structures. A third and less commonly used technique, the short axis in-plan view, aims to combine the benefits of both previous methods. In this technique, the entire needle can be tracked in real time as it enters the IJV, while also providing visualization of surrounding structures.

Conclusions: The short axis in-plane view technique for central venous line placements allows for real-time US-guided needle venipuncture with simultaneous visualization of surrounding structures.

Keywords: jugular vein cannulation; point-of-care ultrasound; short axis in-plane.

MeSH terms

  • Catheterization, Central Venous* / methods
  • Central Venous Catheters*
  • Humans
  • Jugular Veins / diagnostic imaging
  • Ultrasonography
  • Ultrasonography, Interventional / methods