Dynamic SAX vs Conventional LAX in Internal Jugular Vein Catheterization

Study Overview
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Brief Summary
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Conventionally, short-axis out-of-plane (SAX) or long-axis in-plane (LAX) ultrasound views are commonly used to guide internal jugular vein catheterization. SAX dynamic needle tip positioning (SAX-DNTP) is a novel ultrasound imaging technique that enables continuous visualization of the needle tip during ultrasound-guided cannulation; When the needle tip is imaged as a hyperechoic dot, the ultrasound probe is moved a few millimeters, and then the needle is advanced until the needle tip reappears in the vessel lumen. The process is repeated until the needle is advanced more than 1 cm into the lumen. The catheter is then introduced into the vessel. The aim of this study was to compare the first pass success rate of internal jugular vein catheterization between SAX-DNTP and the conventional LAX technique.

Official Title
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Randomized Trial of Ultrasound-guided Right Internal Jugular Vein Catheterization Using Dynamic Short Axis Versus Conventional Long-axis View in Cardiac Surgery Patients: a Dual-center Randomized Trial

Conditions
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Cardiac Surgical Procedures, Central Venous Catheterization, Ultrasonography

Intervention / Treatment
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* Procedure: Dynamic needle tip positioning under ultrasound-guidance
* Procedure: Conventional long-axis view


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elective cardiac surgery where central venous catheterization is required. Exclusion Criteria: skin infection or trauma Shock Patients on ECMO or IABP support Morbid obesity Profound coagulopathy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Dynamic needle tip positioning<br>Dynamic needle tip positioning | Procedure: Dynamic needle tip positioning under ultrasound-guidance<br>* The tip of needle is positioned under ultrasound-guidance using dynamic short-axis view.<br>|
| Active Comparator: Conventional long-axis<br>Conventional long-axis | Procedure: Conventional long-axis view<br>* The tip of needle is positioned under ultrasound-guidance using conventional long-axis in-plane view.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First pass success rate of the internal jugular vein catheterization_confirmation of the central venous pressure through a patient monitor | First pass success rate of the internal jugular vein catheterization_confirmation of the central venous pressure through a patient monitor | Intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total procedure time | Total procedure time | Intraoperative | 
| Rate of posterior wall puncture_assessed by ultrasound | Rate of posterior wall puncture_assessed by ultrasound | Intraoperative |