Clinical trial NCT00951678: Determination of Anatomic Variations of the Internal Jugular and Femoral Veins Using Ultrasound in the Emergency Department
Official title: Determination of Anatomic Variations of the Internal Jugular and Femoral Veins Using Ultrasound in the Emergency Department
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Vascular Anatomy
Keywords: ultrasound
femoral vein
internal jugular vein
Lead sponsor: Tampa General Hospital
Sponsor class: OTHER
First posted: 2009-08-04
Enrollment: 500
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Emergency room patients who fit inclusion criteria and consent to participation in the study.

Brief summary: Central venous catheterization is a common and important procedure done in the emergency department. The internal jugular vein (IJV), subclavian vein (SV) and femoral vein (FV) are commonly used for central venous access. Unfortunately, this procedure has high-risk complications.

Traditionally, physicians have relied on the use of anatomic landmarks and physical manipulation such as moving the head or rotating the leg in order to place central catheters; however, studies have demonstrated that significant anatomic variations exist within large percentages of study populations. In addition, although studies have demonstrated that the use of ultrasonography for placement of femoral catheters leads to lower rates of complications, no previous studies have specifically determined anatomic variations in the femoral triangle. Therefore, this study will examine the anatomic variation of the IJV vs. carotid artery and the femoral vein vs. femoral artery in the emergency room setting. The investigators will study the variation as a function of sex, age, race, body habitus and degree of head rotation (measured using a goniometer) and in doing so, the investigators will demonstrate the utility of using ultrasound to place central lines in order to decrease morbidity.


Eligibility criteria: Inclusion Criteria:

* Patients being cared for in the Tampa General Hospital Emergency Department
* 18 yrs or older
* male or female
* have the anatomy that will be examined (lateral neck and femoral regions)
* speak either English or Spanish
* alert and oriented to person, place, time and situation
* stable vital signs

Exclusion Criteria:

* under 18 yrs
* incarcerated individuals
* those with acute changes in mental status (intoxicated, encephalopathy, psychosis)
* those from whom consent could not be obtained
* those requiring intensive care monitoring
* persons having pathologies that would interfere with the ultrasound investigation
* persons who do not speak English or Spanish
* persons with acute or severe mental or cognitive disabilities
* individuals in a sedated, traumatized or crisis state

Primary outcomes:
measure: To determine the variability that exists within the vascular anatomy of the lateral neck and femoral regions
timeFrame: Within the timeframe of the study
Secondary outcomes:
Other outcomes:
Locations:
city: Tampa
country: United States
facility: Tampa General Hospital
state: Florida
Study officials:
affiliation: USF Emergency Medicine Residency Program
name: Charlotte Derr, MD
role: PRINCIPAL_INVESTIGATOR
References: