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Cavatorta F, Zollo A, Galli S, et al. Ultrasound-guided cannulation and endocavitary electrocardiography placement of internal jugular vein catheters in uremic patients: the importance of routine chest X-ray evaluation. J Vasc Access. 2001;2(2):37-9doi: 10.1177/112972980100200202.
Cavatorta, F., Zollo, A., Galli, S., Mij, M., & Dolla, D. (2001). Ultrasound-guided cannulation and endocavitary electrocardiography placement of internal jugular vein catheters in uremic patients: the importance of routine chest X-ray evaluation. The journal of vascular access, 2(2), 37-9. https://doi.org/10.1177/112972980100200202
Cavatorta, F, et al. "Ultrasound-guided cannulation and endocavitary electrocardiography placement of internal jugular vein catheters in uremic patients: the importance of routine chest X-ray evaluation." The journal of vascular access vol. 2,2 (2001): 37-9. doi: https://doi.org/10.1177/112972980100200202
Cavatorta F, Zollo A, Galli S, Mij M, Dolla D. Ultrasound-guided cannulation and endocavitary electrocardiography placement of internal jugular vein catheters in uremic patients: the importance of routine chest X-ray evaluation. J Vasc Access. 2001 Apr-Jun;2(2):37-9. doi: 10.1177/112972980100200202. PMID: 17638257.
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J Vasc Access. 2001 Apr-Jun;2(2):37-9. doi: 10.1177/112972980100200202.

Ultrasound-guided cannulation and endocavitary electrocardiography placement of internal jugular vein catheters in uremic patients: the importance of routine chest X-ray evaluation.

The journal of vascular access

F Cavatorta, A Zollo, S Galli, M Mij, D Dolla

Affiliations

  1. Department of Nephrology and Dialysis, General Hospital, Imperia - Italy.

PMID: 17638257 DOI: 10.1177/112972980100200202

Abstract

The NKF-DOQI guidelines recommend performing chest-X-ray(CXR) after subclavian and internal jugular vein insertion prior to catheter use. This is to exclude complications such as a pneumothorax before starting hemodialysis. Indication of a central venous dialysis catheter was based on the historic use of the subclavian vein for placement of these catheters and upon the reported incidence of pneumothorax after this approach of between 1% to 12.4%. In contrast, the incidence of these complications using the internal jugular vein (IJV) is much lower (< 1%). We report our experience in ultrasound-guided cannulation of the right IJV for dialysis vascular access in 527 uremic patients and central catheter placement by endocavitary electrocardiography (EC-ECG). Fluoroscopy was not utilized. In the first hundred cases, all patients underwent CXR. Subsequently, because of total absence of complications and catheter tip malpositioning, the CXR control was carried out only in selected cases (repeated cannulation of the jugular vein or absence of P wave). We believe that only in selected cases should a pCXR be performed before starting hemodialysis sessions, and that our method using the right IJV, ultrasound-guided puncture of the vessel, and catheter placement by EC-ECG is a safe and simple technique that avoids the need for CXR control.

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