[Ultrasound-guided puncture of the jugular vein using a posterior approach].

BACKGROUND: Ultrasound-guided central venous catheterization provides a direct view of anatomical structures, making it easier to determine the exact puncture site, thereby reducing the associated mechanical complications.

PATIENTS AND METHODS: This study included patients scheduled for central venous catheterization. An ultrasound examination was performed on the necks of all patients before the right internal jugular vein was catheterized by a single operator using ultrasound monitoring.

RESULTS: We studied 21 men and 14 women; the mean (SD) age of the patients was 53 (17) years. Forty percent were kidney transplant recipients and 57% had had the right internal jugular vein catheterized on other occasions. The carotid artery had accidentally been punctured using the standard catheterization technique in 4 of the patients; the internal jugular vein was then catheterized successfully using ultrasound-guidance, which clearly showed the hematoma caused by the carotid puncture. The right internal jugular vein was successfully catheterized in 34 patients; it was necessary to catheterize the left jugular vein in 1 patient as the ultrasound examination revealed thrombosis of the right vein. A single puncture was performed in all cases and none of the complications associated with venous puncture were observed.

CONCLUSION: Ultrasound images allowed us to effectively examine the jugular vein prior to puncture for central venous catheterization. Ultrasound-guided puncture of the vein was satisfactory and free from complications in all cases.