JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Riopelle, J. M. Articles by Miller, M. K. Search for Related Content PubMed PubMed Citation Articles by Riopelle, J. M. Articles by Miller, M. K.

---

CRITICAL CARE AND TRAUMA

Circumferential Adjustment of Ultrasound Probe Position to Determine the Optimal Approach to the Internal Jugular Vein: A Noninvasive Geometric Study in Adults

James M. Riopelle, MD^*, Darren P. Ruiz, MD^*, John P. Hunt, MD, Mark R. Mitchell, MD^*, J. Carlos Mena, MD^¶, Jason A. Rigol, MD^*, Bruno C. Jubelin, PhD, Arthur J. Riopelle, PhD, Valeriy V. Kozmenko, MD^*, and Matthew K. Miller, MD^*

Departments of *Anesthesiology, Surgery, ¶Radiology, and Medicine, Louisiana State University Health Sciences Center at New Orleans, New Orleans, Louisiana; and Department of Psychology, Louisiana State University, Baton Rouge, Louisiana

Address correspondence and reprint requests to James Riopelle, MD, Anesthesia Department, Charity Hospital, 1532 Tulane Ave., New Orleans, LA 70112. Address e-mail to jriope{at}lsuhsc.edu.

Circumferential adjustment of the position of a two-dimensional ultrasound (US) probe around the neck has been recommended as a strategy for reducing the potential for unintentional common carotid artery puncture during internal jugular venous (IJV) cannulation. We obtained multiple high-resolution US images bilaterally from the necks of 107 adult subjects and analyzed these to determine the degree to which this strategy permits identification of a pathway from the skin to the IJV that minimizes venoarterial overlap while maximizing venous target (angular) width. The method consistently permitted identification of an approach to the IJV superior to that obtainable with any one of four popular surface anatomy-based ("blind") approaches and was even more powerful if used in concert with a US-guided 1) adjustment of the degree of head rotation, 2) choice between a high and low approach, and 3) choice between the right and left IJV. Use of a high-resolution US imaging device also permitted identification of the precise boundaries of additional cervical anatomic structures (nontarget vessels, lymph nodes, and the thyroid gland) potentially relevant to selection of an optimal approach to the IJV.

This article has been cited by other articles:

				E. Saade Error in BMI Calculations Anesth. Analg., September 1, 2005; 101(3): 924 - 924. [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999