The effect of increased abdominal pressure on internal jugular vein catheterization under ultrasound-guidance on conscious patients: A randomised controlled trial.

Background: The shape and cross-sectional area (CSA) of internal jugular vein (IJV) are easily affected by external factors. That causes venous collapsibility. We tried to distend IJV by increasing the pressure on patients' abdomen in order to improve the success rate of internal jugular vein catheterization (IJVC).

Materials And Methods: Patients undergoing IJVC were randomly allocated to two groups: Group 1 and Group 2. For patients in Group 1, the pressure on abdomen was increased by placing a 3000 ml bag of normal saline (NS). No special treatment was arranged for patients in Group 2. Transverse images of right IJV were captured at the outer edge which was parallel to the cricoid by ultrasonography. CSA, circumference (CF), transverse diameter (TD) and anteroposterior diameter (APD) of right IJV were measured and compared. All patients underwent ultrasound-guided short-axis puncturing. The success rates of one-off puncturing in two groups were recorded and compared.

Results: The results under ultrasonography assessments show that CF, CSA, APD and success rate of puncturing in Group 1 were significantly higher than that of Group 2 (P < 0.05), while TD was not significantly increased (P > 0.05). There was no significant difference in complications between two groups (P > 0.05).

Conclusion: Pressure on the abdomen could significantly increase CSA of IJV. That helps improving the success rate of one-off puncturing.