Effect of Shoulder Traction on Size and Relative Position of Internal Jugular Vein to Carotid Artery
Recruitment status was: Recruiting
|Internal Jugular Vein Cannulation Common Carotid Artery Infants||Other: caudo-ipsilateral traction of shoulder Other: The ultrasonographic measurements without shoulder traction|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
|Official Title:||Effect of Shoulder Position and Head Rotation on Size and Relative Position of Internal Jugular Vein to Carotid Artery in Infants and Children|
- Carotid artery (CA) overlap (%) [ Time Frame: 10 seconds after head positioning ]CA overlap = (overlap distance between CA and internal jugular vein)/CA diameter) × 100 measured by ultrasound image
- IJV (internal jugular vein) safety portion (%) [ Time Frame: 10 seconds after head positioning ]IJV safety portion = (1-ovelap distance/IJV diameter) × 100 measured by ultrasound image
- overlap distance (mm) [ Time Frame: 10 seconds after head position ]overlap distance (mm) of carotid artery and internal jugular vein measured by ultrasound image
- jugular to carotid distance (mm) [ Time Frame: 10 seconds after head position ]the distance (mm) between lateral border of carotid artery and center of internal jugula vein measured by ultrasound image
- CA diameter (mm) [ Time Frame: 10 seconds after head positioning ]carotid artery diameter (mm) measured by ultrasound image
- IJV diameter (mm) [ Time Frame: 10 seconds after head positioning ]internal jugualr vein diameter (mm) measured by ultrasound image
|Study Start Date:||August 2011|
|Estimated Study Completion Date:||June 2012|
|Estimated Primary Completion Date:||June 2012 (Final data collection date for primary outcome measure)|
Experimental: Shoulder traction
The ultrasonographic measurements with shoulder traction
Other: caudo-ipsilateral traction of shoulder
After the head rotation (0, 40, 80 degrees) to the contralateral side from the ultrasound measuring site, the slight caudo-ipsilateral traction of shoulder will be applied without changing the degree of the head rotation.
Active Comparator: No traction
The ultrasonographic measurements without shoulder traction
Other: The ultrasonographic measurements without shoulder traction
After the head rotation (0, 40, 80 degrees) to the contralateral side from the ultrasound measuring site, the no traction of shoulder will be applied.
Central venous catheterization is frequently performed in pediatric patients undergoing major surgery for fluid management and vasoactive drug therapy. Compared to subclavian vein, internal jugular vein (IJV) is generally preferred for catheterization because of the low incidence of serious complications, such as pneumothorax and hemothorax. However, especially in infants, IJV catheterization is still technically difficult because of the small size of the vein and anatomical variation.
In previous studies, ultrasound guidance and keeping in neutral head position have been recommended to increase the success rate and to decrease the overlap between carotid artery (CA) and IJV, respectively. However, devices for ultrasonography are not always available. Moreover, IJV catheterization without head rotation could be extremely difficult in infants because of relative the larger skull and the smaller neck than those of adults. Therefore, a simple method to relieve the overlap between CA and IJV would be needed.
During head rotation to the contralateral side, the cephalic part of IJV is moved to the same direction. Accordingly, the investigators thought that the counter traction of the caudal part of IJV using the caudo-lateral traction of the ipsilateral arm might relieve the overlap caused from head rotation. Therefore, the investigators evaluated the effect of the caudo-lateral traction of the ipsilateral arm on the overlap between common CA and IJV in infants.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01575184
|Contact: Jong Hwan Lee, MD, PhDemail@example.com|
|Contact: Ae Ryoung Lee, MDfirstname.lastname@example.org|
|Korea, Republic of|
|Samsung Medical Center||Recruiting|
|Seoul, Korea, Republic of, 135-710|
|Contact: Jong Hwan Lee, MD, PhD 82-2-3410-1928 email@example.com|
|Contact: Won Ho Kim, MD 82-2-3410-2470 firstname.lastname@example.org|
|Sub-Investigator: Jong Hwan Lee, MD, PhD|
|Principal Investigator:||Jong Hwan Lee, MD, PhD||Samsung Medical Center|
|Principal Investigator:||Won Ho Kim, MD||Samsung Medical Center|