Abstract

Background: Central venous cannulation is essential for open heart surgery and critically ill patients. SCV was customarily cannulated by infraclavicular landmark technique. With USG, waves are obscured by bony structures in infraclavicular but clear with supraclavicular approach. Therefore we compared these approaches.

Materials and Methods: 40 patients undergoing open heart surgery were randomly allocated into Group S and Group I. Group S(n=20) underwent SCV cannulation by supraclavicular approach, GroupI (n=20)  by infraclavicular approach. Outcome measures are duration of the procedure, number of attempts, success of cannulation and the complications. Under USG guidance, in supraclavicular approach the vein was cannulated by ‘in plane technique’ and longitudinal axis, in infraclavicular approach by ‘out of plane’ technique and short axis of the vein.

Results: The duration of the procedure (secs) for supraclavicular and infraclavicular approaches were 68.53 + 28.39 and 116.58 + 38.95 respectively with P value of<0.05, hence statistically significant. The number of successful attempts for supraclavicular and infraclavicular approaches were 1.26 + 0.375 and 1.21 + 0.42 respectively and the success rate was 95.0% for both approaches.

Conclusion: USG guided SCVcannulation is easy and rapid to perform with supraclavicular approach.

Keywords: SCV cannulation, Supra clavicular, Infraclavicular, Ultrasound guidance.