A study on complications in ultrasound guided catheterization of the internal jugular vein.

Background: With the advanced knowledge in medical monitoring, ever increasing value has been placed on the establishment of central venous catheter. During the past few years, monitoring of central venous pressure has become an important aid in the management of critically ill patients. Doppler ultrasound was first used to assist central venous catheter insertion in 1984. Ultrasound has been applied to describe the anatomy of the IJV and to evaluate various techniques for percutaneous cannulation. Real time sonography improves access to the vein compared with the traditional method. Ultrasound guided cannulation limits complications and also the decreases the cannulation time. For reducing the complication in traditional method we have conducted the study through ultrasound guide and observed the complications in new method. Methods: Thirty critical care patients were selected for IJV cannulation either by ultrasound guided technique. This study conducted in department of anesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. Results: In our study there was 100% success rate for first attempt cannulation in USG technique. The mean access time in USG technique was 152.50 ± 63.90 sec. in USG technique arrhythmias were noted in 1 (3.3%) case during the study. No cases of haematoma, pneumothorax, haemothorax, nerve Injury, carotid artery puncture and catheter malposition were noted during the study in USG technique. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure.

study on complications in land mark technique catheterization of internal jugular vein.

Background: The traditional methods of using anatomic landmarks to guide cannulation of the IJV have yielded various rates of successful access and complications. Moreover, central venous catheterization requires considerable expertise. Cannulation of the IJV was first described in 1969. Various positions were used to access cannulation but they were frequently associated with complications such as arterial puncture, pneumothorax, neurological damage, infection, dysrhythmias, atrial thrombus, cardiac rupture. Methods: Thirty critical care patients were selected for IJV cannulation either by Land mark technique. This study conducted in department of anaesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. India. Results: In our study there was 83.3% success in LMG technique. The mean access time was 323.23 ± 146.19 sec and the distribution of complications encountered during the study, Carotid artery was accidentally punctured in 1 (3.3%) cases. In LMG technique, there were no cases of arrhythmias, haematoma, pneumothorax, haemothorax, nerve injury and catheter malposition were noted during the study. Conclusion: Land mark technique catheterization of internal jugular vein was shown complications than newly developed ultrasound guided method.

A Comparative Study between Ultrasound Guided Catheterization of the Internal Jugular Vein and Classical Land Mark Technique.

Background: Catheterization of Internal Jugular Vein (IJV) is commonly attempted to obtain central venous access for hemodynamic monitoring, long term administration of fluids, total parenteral nutrition and hemodialysis in critical care patients. The safe puncture of the IJV is achieved by using anatomical land marks on skin surface. Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, decreasing access time and decreasing complications. Material andMethods: Sixty critical care patientswere selected for IJV cannulation either by landmark technique or by ultrasound guided technique in two groups of thirty each. Results: In our study there was 100% success rate for first attempt cannulation in USG technique and where as it was 83.3% in LMG technique. The mean access time in USG technique was 152.50 ± 63.90 sec as against 323.23 ± 146.19 sec in LMG group. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure.

Osteometric study of human femur.

Skeleton is playing important role in various like Medicine, Forensic sciences, Anthropology etc. Estimation of sex, age, race, stature by skeleton and the presence of disease is discovered by Krogman and Iscan (1986). Sex is determined after death by skeletal remains of that individual by some forensic anthropologists with the help of pelvis, skull and long bones. The study was undertaken in 50 femurs for measuring epicondylar breadth, Neck shaft angle, transverse and vertical diameter of head. The results were the average meanepicondylar breadth was 75.6 ± 6.06mm, mean right epicondylar breadth was 73.96 ± 4.99mm and left it was 76.35 ± 7.0mm. The average mean neck shaft angle was 125.3 ± 6.50mm, mean right neck shaft angle was 124.44 ± 5.7mm and left it was 126.3 ± 7.33mm. The average mean transverse diameter of head was 37.86 ± 3.06mm, mean right transverse diameter of head was 37.74 ± 3.05mm and left it was 38.00 ± 3.13mm. The average mean vertical diameter of head was 42.24 ± 3.53mm, mean right vertical diameter of head was 41.63 ± 3.09mm and left it was 42.96 ± 3.92mm, Neck shaft angle ranges from a minimum of 106° to maximum 135° with a mean value of 125.3°. The knowledge of osteometric values is helpful to anthropological and forensic practice.