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Ultrasound-Guided Vascular Catheterization

Clinician's Brief (Capsule)

Internal Medicine

|July 2014

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An ultrasound-guided technique to achieve jugular vein catheterization in a cardiac arrest dog model was evaluated. Obtaining vascular access in an emergency situation is critical. However, access in hypotensive or hypovolemic patients can be challenging, and unsuccessful attempts often produce hematomas. Studies of ultrasound-guided vascular access in humans have realized a higher success rate and fewer complications.

Cardiac arrest was induced in 9 walker hounds. One of 3 randomly assigned operators attempted to place a jugular catheter with ultrasound guidance; 27 attempts were made. Simulated hematomas were created in 9 patients by injecting 5–15 mL of blood in SC tissue around the vein. Alcohol was applied to all catheterization sites and proved sufficient for obtaining an ultrasound image. Mean time to vascular access without a hematoma was 1.9 minutes and 4.3 minutes with a hematoma. Perceived difficulty in placing the jugular catheter was the same; however, individuals did perceive the initial catheterization attempts to be more difficult. This learning curve was shallow, thus showing that individuals can easily learn the ultrasound-guided technique. Keeping the vessel and catheter tip in the same plane as the ultrasound probe was important. The authors concluded that further studies are required to evaluate the ultrasound-guided technique.


Ultrasonography has become popular in emergency and critical care as a diagnostic tool for identifying and sampling cavitary fluid/air accumulation and anatomic organ changes in the critically ill and injured patient and as an instrument to facilitate nonsurgical, interventional techniques (eg, obtaining vascular access, administering nerve blocks). This study suggested that using ultrasonography to guide jugular vein catheterization may reduce failure rates when percutaneously obtaining IV access. For veterinarians who use ultrasonography regularly, the technique can be practiced on recently deceased patients, thus potentially improving its implementation on live patients. This technique may be useful for veterinary technicians who work in states that do not permit them to perform surgical cut-down procedures for vascular access.—Elke Rudloff, DVM, DACVECC


Evaluation of ultrasound-guided vascular access in dogs. Chamberlin SC, Sullivan LA, Morley PS, Boscan P. JVECC 23:498-503, 2013.

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