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Punción ecodirigida de la vena yugular internapor abordaje posterior / Ultrasound-guided puncture of the jugular vein using a posterior approach

INTRODUCCIÓN: La canalización de vías centrales guiadapor ultrasonidos permite una visualización directa delas estructuras anatómicas lo cual facilita una determinaciónexacta del punto de punción, disminuyendo lascomplicaciones mecánicas asociadas.PACIENTES Y MÉTODO: Se incluyeron pacientes candidatosa la colocación de un catéter central. En todos ellosse exploró ecográficamente el cuello y posteriormente seprocedió a canalizar la vena yugular interna derecha porun solo operador bajo control ecográfico.RESULTADOS: Fueron estudiados 21 hombres y 14mujeres con una edad promedio de 53 ± 17 años. El 40%de los pacientes fueron sometidos a trasplante renal y al57% se les había canalizado en otras ocasiones la venayugular interna derecha. A 4 pacientes se les había puncionadoaccidentalmente la arteria carótida utilizando latécnica habitual y posteriormente se canalizó la venayugular interna por medio de punción ecodirigida sinincidencias, pudiéndose visualizar el hematoma formado.En un total de 34 pacientes se canalizó con éxito lavena yugular interna derecha, mientras que en uno tuvoque ser la izquierda al objetivarse durante la exploraciónecográfica una trombosis de la derecha. En todosellos se realizó una única punción cutánea y no se observóninguna complicación asociada a la venopunción.CONCLUSIÓN: El uso de ultrasonidos para la canalizaciónde las vías centrales ha resultado eficaz en la valoraciónprepunción del estado de la yugular y su punciónecodirigida ha resultado satisfactoria y sin complicacionesen todos los casos (AU)

BACKGROUND: Ultrasound-guided central venouscatheterization provides a direct view of anatomicalstructures, making it easier to determine the exactpuncture site, thereby reducing the associated mechanicalcomplications.PATIENTS AND METHODS: This study included patientsscheduled for central venous catheterization. An ultrasoundexamination was performed on the necks of all patientsbefore the right internal jugular vein was catheterized by asingle operator using ultrasound monitoring.RESULTS: We studied 21 men and 14 women; the mean(SD) age of the patients was 53 (17) years. Forty percentwere kidney transplant recipients and 57% had had theright internal jugular vein catheterized on other occasions.The carotid artery had accidentally been punctured usingthe standard catheterization technique in 4 of the patients;the internal jugular vein was then catheterized successfullyusing ultrasound-guidance, which clearly showed thehematoma caused by the carotid puncture. The rightinternal jugular vein was successfully catheterized in 34patients; it was necessary to catheterize the left jugularvein in 1 patient as the ultrasound examination revealedthrombosis of the right vein. A single puncture wasperformed in all cases and none of the complicationsassociated with venous puncture were observed.CONCLUSION: Ultrasound images allowed us toeffectively examine the jugular vein prior to puncturefor central venous catheterization. Ultrasound-guidedpuncture of the vein was satisfactory and free fromcomplications in all casess (AU)

[Ultrasound-guided puncture of the jugular vein using a posterior approach]. / Punción ecodirigida de la vena yugular interna por abordaje posterior.

BACKGROUND: Ultrasound-guided central venous catheterization provides a direct view of anatomical structures, making it easier to determine the exact puncture site, thereby reducing the associated mechanical complications. PATIENTS AND METHODS: This study included patients scheduled for central venous catheterization. An ultrasound examination was performed on the necks of all patients before the right internal jugular vein was catheterized by a single operator using ultrasound monitoring. RESULTS: We studied 21 men and 14 women; the mean (SD) age of the patients was 53 (17) years. Forty percent were kidney transplant recipients and 57% had had the right internal jugular vein catheterized on other occasions. The carotid artery had accidentally been punctured using the standard catheterization technique in 4 of the patients; the internal jugular vein was then catheterized successfully using ultrasound-guidance, which clearly showed the hematoma caused by the carotid puncture. The right internal jugular vein was successfully catheterized in 34 patients; it was necessary to catheterize the left jugular vein in 1 patient as the ultrasound examination revealed thrombosis of the right vein. A single puncture was performed in all cases and none of the complications associated with venous puncture were observed. CONCLUSION: Ultrasound images allowed us to effectively examine the jugular vein prior to puncture for central venous catheterization. Ultrasound-guided puncture of the vein was satisfactory and free from complications in all cases.