Modification of low-located catheterization of the internal jugular vein and its clinical application

Objective:To modify the method of the low-located catheterization of internal jugular vein and verify its clinical application. Methods: 400 cases of the patients with hepatobiliary surgeries were randomly selected for right internal jugular vein catheterization. The site for puncture is located at the anterior edge of the sternocleidomastoid muscle, 2.0~2.5cm above the superior edge of clavicle. The direction of the puncture needle is toward to the lateral border of the clavicular head of sternocleidomastoid muscle. Results:The successful rates of times of the initial puncture showed that 354 cases (88.50%) underwent only one time puncture, 38 cases(9.50%)underwent twice and 8 cases(2.00%) underwent 3 times or more respectively. Five cases were changed to choose the other alternative pathways. The successful rates of the times of formal puncture and catheterization were that one time puncture and catheterization in 349 cases(87.25%), twice in 37 cases(9.25%)underwent twice and 3 times or more in 9 cases(2.25%). Five cases were adapted to other alternative pathways to achieve the success of catheterization. Arterial puncture occurred in 4 cases( 0.10% ).None of the pneumothorax or other serious complications happened. Conclusions:The modified method for internal jugular vein catheterization in low-located site is a very convenient maneuver, which is easy to handle, with high successful rate and decreased complications. It is worth to be widely utilized in clinical practice.