Publications

ABSTRACT
Introduction: The standard approaches to ultrasound-guided
central line insertion by Short Axis (SAX) and Long Axis (LAX)
have limitations. The Medial Oblique Axis (M-OAX) approach
allows visualisation of the length of the needle in real-time along
with both the artery and vein.
Aim: To compare the three approaches for ultrasound-guided
right Internal Jugular Vein (IJV) cannulation with respect to ease
of access and complications.
Materials and Methods: A total of 171 patients scheduled to
undergo right IJV cannulation were divided equally into three
groups-SAX (Group-1), LAX (Group-2), and M-OAX (Group-3).
They were compared with respect to first pass success, Venous
Access Time (VAT), guide wire insertion time, catheterisation
time, and complications. Continuous variables were compared
with Analysis of Variance (ANOVA) test. Categorical variables
were analysed using the Chi-square test. The p-value <0.05
was considered significant.
Results: First pass success was 55 (96.49%), 53(92.98%),
and 54 (94.74%) in groups 1, 2, and 3, respectively. The
VAT, guidewire insertion time, and catheterisation time were
significantly lesser in Groups 1 and 3 compared to 2 (p<0.001).
Two cases of carotid artery puncture were noted in Group-2,
though statistically not significant (p>0.05).
Conclusion: The medial oblique approach to IJV cannulation
combines the advantages of both LAX and SAX and is a safer
alternative with easier and faster venous access.