Alagöz Ali, Tunç Mehtap, Sazak Hilal, Pehlivanoğlu Polat, Gökçek Atila, Ulus Fatma
Department of Anaesthesiology and Reanimation, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
Department of Radiology, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
Turk J Anaesthesiol Reanim. 2015 Jun;43(3):212-4. doi: 10.5152/TJAR.2015.82713. Epub 2015 Feb 16.
Cannulation of the internal jugular vein (IJV) may be diffucult because of anatomical variations. A 66-year-old female patient, who was in the intensive care unit, underwent ultrasound-guided cannulation of the right IJV. The right IJV could not be visualized by ultrasonography despite positional changes of the patient and Valsalva maneuvre. The left IJV was easily determined by ultrasonography and cannulated. Although the landmark technique may be sufficient for most of the central vein cannulations, the rate of anatomical variations and related complications is quite high. We point out that even if ultrasound cannot be used in real-time, the ultrasonographic confirmation during the pre-insertion period may be crucial for successful central vein cannulation.
由于解剖变异，颈内静脉插管可能会很困难。一位66岁的女性患者在重症监护病房接受了超声引导下的右侧颈内静脉插管。尽管患者改变了体位并进行了瓦尔萨尔瓦动作，但超声检查仍无法显示右侧颈内静脉。左侧颈内静脉通过超声检查很容易确定并成功插管。尽管标志性技术可能足以用于大多数中心静脉插管，但解剖变异率和相关并发症相当高。我们指出，即使不能实时使用超声，插入前的超声确认对于中心静脉插管的成功可能至关重要。
