Sonographically-guided puncture technique for central venous vessels as a one-person procedure.

Aim: The traditional anatomic landmark technique usually allows a rapid and easy central venous access but this technique is not always successful and can be associated with severe complications. We developed an ultrasonicall y guided one-operator-catheterization technique whereas a second operator t o place and hold the ultrasound transducer is not necessary. Method: The ca theterisation technique consists of 3 functional components: the swivel arm , the ultrasound unit and the conventional Seldinger central venous cathete rization technique. As swivel arm we used a device with a 300 mm column wit h a 700 mm span attached to ultrasound unit. There were 234 catheterization s of the internal jugular vein performed in the period of January 1999 to J uly 1999. The indication and complication rate for the catheterization proc edure was documented. Results: There were 2 plexus irritations and 1 hemato ma observed in all performed catheterization procedures which remained with out therapeutic consequences. Conclusion: Once the decision for central ven ous access has been made the safest technique should be applied. The ultras onically guided catheterization technique allows a fast, safe and convenien t central venous access for our patients.