BJA Advance Access published online on June 25, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh187
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Department of Anaesthesia, General Infirmary at Leeds, Leeds Teaching Hospitals, Great George Street, Leeds LS1 3EX, UK
* To whom correspondence should be addressed. E-mail: andy.bodenham{at}leedsth.nhs.uk.
Background. Infraclavicular axillary vein cannulation is not commonly used for central venous access because identifying the surface landmarks is difficult. Ultrasound guided axillary vein puncture has not been well described. We assessed ultrasound imaging to guide catheterization of the infraclavicular axillary vein. Methods. In 200 consecutive patients we attempted to catheterize the axillary vein using ultrasound imaging. After successful venepuncture, a tunnelled Hickman line was inserted for long-term central venous access. Surface landmarks of the skin puncture site were measured below the clavicle. We measured the depth of the vein from the skin, the length of the guidewire from skin to carina and the final length of catheter that was inserted. Results. The axillary vein was successfully punctured with the help of ultrasound imaging with first needle pass in 76% of patients. The axillary vein was catheterized successfully in 96% of the cases. Guidewire malposition was detected and corrected by fluoroscopy in 15% of cases. Complications included axillary artery puncture in three (1.5%) and transient neuralgia in two (1%) cases. Conclusion. Ultrasound-guided catheterization of the infraclavicular axillary vein is a useful alternative technique for central venous cannulation with few complications.
Clinical Investigation
Ultrasound-guided infraclavicular axillary vein cannulation for central venous access
Abstract 
This article is accompanied by Editorial II.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. Pirotte and F. Veyckemans Ultrasound-guided subclavian vein cannulation in infants and children: a novel approach Br. J. Anaesth., April 1, 2007; 98(4): 509 - 514. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Gabal and A. Bodenham Imaging of the axillary vein. Br. J. Anaesth., September 1, 2006; 97(3): 426 - 426. [Full Text] [PDF]
|
|
|
|
 |
|
 A Hatfield and A Bodenham Ultrasound for central venous access CEACCP, December 1, 2005; 5(6): 187 - 190. [Full Text] [PDF]
|
|
|
|
|
|
A. R. Bodenham Massive subcutaneous emphysema after accidental removal of an intercostal drain Br. J. Anaesth., July 1, 2005; 95(1): 110 - 110. [Full Text] [PDF]
|
|
|
|
|
|
S. P. Mackey, S. Sinha, J. Pusey, A. R. Bodenham, and S. Galloway Ultrasound imaging of the axillary vein--anatomical basis for central venous access Br. J. Anaesth., October 1, 2004; 93(4): 598 - 599. [Full Text] [PDF]
|
|
|
|
|
|
D. H. T. Scott Editorial II: The king of the blind extends his frontiers Br. J. Anaesth., August 1, 2004; 93(2): 175 - 177. [Full Text] [PDF]
|
|