Abstract :
Background and Aim: To compare the efficacy of USG guided central venous catheterisation at internal jugular vein (IJV) and at the Pirogoff’s confluence [IJV, subclavian vein (SCV), Brachiocephalic Vein (BCV)].
Materials and Methods: A prospective, comparative, randomized, hospital based study was conducted on 100 patients requiring central venous access. After explaining the study to the selected patients, they were randomized into two groups with the use of sealed envelope method i.e. group A (Central venous cannulation of IJV) and group B (central venous cannulation of Pirogoff’s confluence of IJV, SCV, BCV). Data was collected with respect to the efficacy of USG guided cannulation on the basis of time for visualisation, access time, number of attempts, time to CVC, total time of procedure, length of catheter inserted. Any complications encountered were recorded.
Results: There was no difference between number of attempts in either of groups, mean visualization, access time and time to CVC was longer in group B with statistically significant difference. Mean length of catheter inserted was shorter in group B with statistical significant difference. Procedure time required was comparatively more in group B.
Conclusion: The results indicated that Ultrasound guided cannulation of group A is efficacious than group B in terms of time required to culminate the procedure as well as complications but cannulation of Pirogoff’s confluence is a novel approach giving easier access, better visualisation and length of catheter inserted is lesser than IJV.
Keyword :
Cannulation, Pirogoff's confluence, Central venous cannulation, IJV