ULTRASOUND-GUIDED CANNULATION OF THE INTERNAL JUGULAR-VEIN FOR DIALYSIS VASCULAR ACCESS IN UREMIC PATIENTS

Background: A reliable temporary vascular access is always required fo r hemodialysis when a permanent vascular access is not available. Howe ver, techniques for creating temporary vascular accesses remain imperf ect. This study utilized the 'SiteRite' ultrasound device to improve b oth success and complication rates of jugular venous cannulation for t emporary access. Methods: This prospective, comparative study recruite d 104 uremic patients receiving ultrasound-guided and 86 patients unde rgoing landmark-guided percutaneous internal jugular venous cannulatio n of dual-lumen dialysis catheters, Success rate, number of puncture a ttempts, access time, and the complication rate of the ultrasound tech nique, in comparison with the landmark-guided technique, were studied. Results: The ultrasound-guided cannulation was superior to the extern al landmark-guided cannulation in overall success rate (99.0 vs. 86.0% , p < 0.01), success rate of the first puncture attempt (80.8 vs. 34.9 %, p < 0.01), average puncture (access) times (15.8 vs. 43.7 s, p < 0. 01), puncture trials (1.39 vs. 2.58, p < 0.01), and traumatic complica tion rate (1.9 vs. 11.6%, p = 0.015). The incidence of infective compl ications for the ultrasound group was not different from that of the l andmark-guided groups (2.9 vs. 2.3%, p = 0.589). Conclusion: The ultra sound-guided technique offers both safety and convenience in inserting jugular venous dialysis catheters, It represents a valuable technique in creating temporary dialysis hemoaccesses.