TY - JOUR
T1 - Catheterization Without Supination - A Series of 36 Prone Position Internal Jugular Vein Cannulations
AU - Lussier, Bethany L.
AU - Pham, David T.
AU - Ratti, Gregory A.
AU - Patel, Jiten
AU - Mitchell, Brandon C.
AU - Chen, Catherine
N1 - Publisher Copyright:
© 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2022/12/30
Y1 - 2022/12/30
N2 - OBJECTIVES: Describe the clinical characteristics and outcomes of 32 critically ill patients who underwent central venous cannulation of the internal jugular vein while in prone position. DESIGN: Retrospective cohort analysis. SETTING: Single tertiary-care urban academic safety-net hospital. PATIENTS/SUBJECTS: Patients requiring mechanical ventilation and prone positioning for severe acute respiratory distress syndrome from March 1, 2020, through March 31, 2021. INTERVENTIONS: Internal jugular vein cannulation while in the prone position. MEASUREMENTS AND MAIN RESULTS: The technique used for venous access, procedural complications, patient demographics, and clinical outcomes are described. Thirty-six prone internal jugular vein cannulations for 32 hemodialysis catheters and four central venous catheters were successfully performed in 32 patients. One immediate and one delayed pneumothorax occurred. Inhospital mortality was 88%. CONCLUSIONS: In the largest series to date, cannulation of the internal jugular vein with the patient in prone position is feasible but associated with a 6% risk of pneumothorax. Severity of illness in patients intolerant of supine positioning results in high inhospital mortality.
AB - OBJECTIVES: Describe the clinical characteristics and outcomes of 32 critically ill patients who underwent central venous cannulation of the internal jugular vein while in prone position. DESIGN: Retrospective cohort analysis. SETTING: Single tertiary-care urban academic safety-net hospital. PATIENTS/SUBJECTS: Patients requiring mechanical ventilation and prone positioning for severe acute respiratory distress syndrome from March 1, 2020, through March 31, 2021. INTERVENTIONS: Internal jugular vein cannulation while in the prone position. MEASUREMENTS AND MAIN RESULTS: The technique used for venous access, procedural complications, patient demographics, and clinical outcomes are described. Thirty-six prone internal jugular vein cannulations for 32 hemodialysis catheters and four central venous catheters were successfully performed in 32 patients. One immediate and one delayed pneumothorax occurred. Inhospital mortality was 88%. CONCLUSIONS: In the largest series to date, cannulation of the internal jugular vein with the patient in prone position is feasible but associated with a 6% risk of pneumothorax. Severity of illness in patients intolerant of supine positioning results in high inhospital mortality.
KW - acute respiratory distress syndrome
KW - central venous cannulation
KW - coronavirus
KW - prone positioning
KW - severe acute respiratory syndrome
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U2 - 10.1097/CCE.0000000000000831
DO - 10.1097/CCE.0000000000000831
M3 - Article
C2 - 36600779
AN - SCOPUS:85147126628
SN - 2639-8028
VL - 5
SP - E0831
JO - Critical Care Explorations
JF - Critical Care Explorations
IS - 1
ER -