Ultrasound-guided catheterization of the internal jugular vein in oncologic patients; comparison with the classical anatomic landmark technique: a prospective study.

AIM: To compare the traditional anatomic landmark technique with the ultrasound-guided method for central venous catheterization.

MATERIAL AND METHODS: During three years, 551 patients underwent internal jugular vein catheterization; in 347 patients, the ultrasound-guided technique was used, while in the other 204 patients the catheter was introduced by using the classical anatomic landmark method. Operating time, complications (pneumothorax, puncture of carotid artery with or without hematoma formation), and number of attempts to achieve central venous catheterization were recorded.

RESULTS: The ultrasound-guided technique was associated with significantly shorter operating time (9.83+/-3.1 vs. 20+/-4.4 min, p<0.001) and less morbidity (pneumothorax, 0 vs. 2 patients [p<0.05], carotid artery puncture with or without hematoma formation, 1 vs. 16 patients [p<0.05]). Moreover, the ultrasound-guided technique was highly successful in achieving central venous catheterization (failure, 0 vs. 18 patients [p<0.05]), with significantly fewer attempts (1-3 attempts in 204 vs. 283 [p<0.01]), compared to the classical anatomic landmark technique.

CONCLUSION: The ultrasound-guided method is faster, more efficient, and less morbid procedure compared with the classical anatomic landmark technique. Therefore, it should be preferred over the classical landmark method, especially in high-risk patients for the development of complications.