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Critical Care (London, England) Aug 2017The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In... (Review)
Review
The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In this review, we describe the rationale for the use of US during CVC placement, the basic principles of this technique, and the current evidence and existing guidelines for its use. In addition, we recommend a structured approach for US-guided central venous access for clinical practice. Static and real-time US can be used to visualize the anatomy and patency of the target vein in a short-axis and a long-axis view. US-guided needle advancement can be performed in an "out-of-plane" and an "in-plane" technique. There is clear evidence that US offers gains in safety and quality during CVC placement in the internal jugular vein. For the subclavian and femoral veins, US offers small gains in safety and quality. Based on the available evidence from clinical studies, several guidelines from medical societies strongly recommend the use of US for CVC placement in the internal jugular vein. Data from survey studies show that there is still a gap between the existing evidence and guidelines and the use of US in clinical practice. For clinical practice, we recommend a six-step systematic approach for US-guided central venous access that includes assessing the target vein (anatomy and vessel localization, vessel patency), using real-time US guidance for puncture of the vein, and confirming the correct needle, wire, and catheter position in the vein. To achieve the best skill level for CVC placement the knowledge from anatomic landmark techniques and the knowledge from US-guided CVC placement need to be combined and integrated.
Topics: Catheterization, Central Venous; Central Venous Catheters; Clinical Competence; Humans; Jugular Veins; Ultrasonography, Interventional
PubMed: 28844205
DOI: 10.1186/s13054-017-1814-y -
European Journal of Heart Failure May 2021Congestion, related to pressure and/or fluid overload, plays a central role in the pathophysiology, presentation and prognosis of heart failure and is an important... (Review)
Review
Congestion, related to pressure and/or fluid overload, plays a central role in the pathophysiology, presentation and prognosis of heart failure and is an important therapeutic target. While symptoms and physical signs of fluid overload are required to make a clinical diagnosis of heart failure, they lack both sensitivity and specificity, which might lead to diagnostic delay and uncertainty. Over the last decades, new ultrasound methods for the detection of elevated intracardiac pressures and/or fluid overload have been developed that are more sensitive and specific, thereby enabling earlier and more accurate diagnosis and facilitating treatment strategies. Accordingly, we considered that a state-of-the-art review of ultrasound methods for the detection and quantification of congestion was timely, including imaging of the heart, lungs (B-lines), kidneys (intrarenal venous flow), and venous system (inferior vena cava and internal jugular vein diameter).
Topics: Delayed Diagnosis; Heart Failure; Humans; Jugular Veins; Ultrasonography; Vena Cava, Inferior
PubMed: 33118672
DOI: 10.1002/ejhf.2032 -
Journal of Anesthesia Apr 2020Central venous catheterization is a basic skill applicable in various medical fields. However, because it may occasionally cause lethal complications, we developed this... (Review)
Review
Central venous catheterization is a basic skill applicable in various medical fields. However, because it may occasionally cause lethal complications, we developed this practical guide that will help a novice operator successfully perform central venous catheterization using ultrasound guidance. The focus of this practical guide is patient safety. It details the fundamental knowledge and techniques that are indispensable for performing ultrasound-guided internal jugular vein catheterization (other choices of indwelling catheters, subclavian, axillary, and femoral venous catheter, or peripherally inserted central venous catheter are also described in alternatives).
Topics: Catheterization, Central Venous; Catheterization, Peripheral; Catheters, Indwelling; Humans; Jugular Veins
PubMed: 31786676
DOI: 10.1007/s00540-019-02702-9 -
Ugeskrift For Laeger Apr 2023Pseudoaneurysms and thrombosis in the jugular vein are very rare. This case report presents a case of a 57-year-old female with a thrombosis in the internal jugular vein...
Pseudoaneurysms and thrombosis in the jugular vein are very rare. This case report presents a case of a 57-year-old female with a thrombosis in the internal jugular vein and a pseudoaneurysm in the external jugular vein. The diagnosis is often delayed due to the less-frequent occurrence of either. Ultrasound and/or computer tomographic scan are useful in the diagnostic process. Pseudoaneurysms in the external jugular vein are often benign and treatment spans from none to surgical removal. The treatment of venous thrombosis is anticoagulant medication.
Topics: Female; Humans; Middle Aged; Aneurysm, False; Jugular Veins; Thrombosis; Venous Thrombosis; Subclavian Vein
PubMed: 37114571
DOI: No ID Found -
Lakartidningen Feb 2018The purpose of this case report and discussion is to heighten the awareness of Lemierres syndrome (postanginal sepsis). Affected patients present in various fields of...
The purpose of this case report and discussion is to heighten the awareness of Lemierres syndrome (postanginal sepsis). Affected patients present in various fields of medicine and an increased incidence of "the forgotten disease" may be expected. Fusobacterium necrophorum is the most common pathogen. The clinical course includes a primary head or neck infection with thrombosis of the internal jugular vein with subsequent septic pulmonary embolization. The syndrome bears considerable morbidity and even mortality. People aged 15-25 years are commonly affected. Early diagnosis through positive blood culture and confirmation of jugular vein thrombosis combined with prompt antibiotic treatment and source control is mandatory in the management of Lemierre's syndrome. Assessment of vital organ function is recommended across the continuum of care as this facilitates recognition and initiation of therapeutic measures to counteract a complicated clinical course.
Topics: Adolescent; Anti-Bacterial Agents; Female; Fusobacterium necrophorum; Humans; Jugular Veins; Lemierre Syndrome; Sepsis; Tomography, X-Ray Computed; Tonsillitis; Venous Thrombosis
PubMed: 29406559
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Sep 2021: Launay's external carotid vein (ECV) is poorly represented in the anatomical literature, although it is an occasional satellite of the external carotid artery (ECA)....
: Launay's external carotid vein (ECV) is poorly represented in the anatomical literature, although it is an occasional satellite of the external carotid artery (ECA). We aimed to establish the incidence and morphology of the ECV. : One hundred computed tomography angiograms were investigated, and ECVs were documented anatomically, when found. : Launay's vein was found in 3/200 sides (1.5%) in a male and two female cases. In two of these cases, the ECV was a replaced variant of the anterior division of the retromandibular vein (RMV), and the facial vein (FV) ended in the external jugular vein. In the third case with the ECV, the RMV was absent and the common FV that resulted from that ECV and the FV drained into the internal jugular vein. The ECV could also appear as an accessory RMV, not just as a replaced one. Additional variants were found, such as fenestration of the external jugular vein (EJV), the extracondylar vein draining the deep temporal veins and an arterial occipitoauricular trunk. : Surgical dissections of the ECA in the retromandibular space should carefully observe an ECV to avoid unwanted haemorrhagic events. Approaches of the neck of the mandible should also carefully distinguish the consistent extracondylar veins.
Topics: Angiography; Drainage; Female; Humans; Jugular Veins; Male; Mandible; Veins
PubMed: 34577908
DOI: 10.3390/medicina57090985 -
European Annals of Otorhinolaryngology,... Apr 2016Lemierre syndrome is a complication of oropharyngeal infection and consists of a combination of internal jugular vein septic thrombophlebitis with septicaemia and...
INTRODUCTION
Lemierre syndrome is a complication of oropharyngeal infection and consists of a combination of internal jugular vein septic thrombophlebitis with septicaemia and distant septic emboli (mainly in the lungs). We describe an atypical case with facial vein and anterior jugular vein thrombophlebitis.
CASE SUMMARY
A 34-year-old woman attended the emergency room with tonsillitis, left head and neck cellulitis, left facial vein thrombosis and lung abscesses. A diagnosis of atypical Lemierre syndrome was proposed and the patient was treated surgically (neck incision and tonsillectomy) and medically (antibiotics, hyperbaric oxygen therapy and anticoagulation) allowing cure without sequelae.
DISCUSSION
Lemierre syndrome, a rare but serious complication requiring immediate treatment, should be investigated (by blood cultures and chest CT scan) in the presence of neck vein thrombosis complicating oropharyngeal infection.
Topics: Adult; Face; Female; Humans; Jugular Veins; Lemierre Syndrome; Thrombophlebitis
PubMed: 26718846
DOI: 10.1016/j.anorl.2015.12.001 -
CNS Neuroscience & Therapeutics Jun 2018Extracranial venous abnormalities, especially jugular venous outflow disturbance, were originally viewed as nonpathological phenomena due to a lack of realization and... (Review)
Review
Extracranial venous abnormalities, especially jugular venous outflow disturbance, were originally viewed as nonpathological phenomena due to a lack of realization and exploration of their feature and clinical significance. The etiology and pathogenesis are still unclear, whereas a couple of causal factors have been conjectured. The clinical presentation of this condition is highly variable, ranging from insidious to symptomatic, such as headaches, dizziness, pulsatile tinnitus, visual impairment, sleep disturbance, and neck discomfort or pain. Standard diagnostic criteria are not available, and current diagnosis largely depends on a combinatory use of imaging modalities. Although few researches have been conducted to gain evidence-based therapeutic approach, several recent advances indicate that intravenous angioplasty in combination with stenting implantation may be a safe and efficient way to restore normal blood circulation, alleviate the discomfort symptoms, and enhance patients' quality of life. In addition, surgical removal of structures that constrain the internal jugular vein may serve as an alternative or adjunctive management when endovascular intervention is not feasible. Notably, discussion on every aspect of this newly recognized disease entity is in the infant stage and efforts with more rigorous designed, randomized controlled studies in attempt to identify the pathophysiology, diagnostic criteria, and effective approaches to its treatment will provide a profound insight into this issue.
Topics: Animals; Cerebrovascular Disorders; Humans; Jugular Veins; Regional Blood Flow
PubMed: 29687619
DOI: 10.1111/cns.12859 -
BMJ Case Reports Oct 2018
Topics: Aged, 80 and over; Blood Pressure; Echocardiography; Humans; Jugular Veins; Male; Pericarditis, Constrictive
PubMed: 30333203
DOI: 10.1136/bcr-2018-226820 -
The Laryngoscope Jul 2016We present three cases of duplicated or fenestrated internal jugular veins in patients undergoing neck dissection, including the first known case of concomitant bovine... (Review)
Review
We present three cases of duplicated or fenestrated internal jugular veins in patients undergoing neck dissection, including the first known case of concomitant bovine aortic arch. The prevalence of this anomaly is 1.0% (three out of 295 patients). Internal jugular vein duplication and fenestration may risk iatrogenic injury to the vasculature and spinal accessory nerve during neck dissection. The existence of this anatomic abnormality should be considered when variation of the internal jugular vein is encountered. The objective of this report is to discuss the presentation, clinical implications, and literature pertaining to internal jugular vein duplication and fenestration. Laryngoscope, 126:1585-1588, 2016.
Topics: Accessory Nerve; Aged; Aorta, Thoracic; Female; Humans; Jugular Veins; Male; Middle Aged; Neck Dissection
PubMed: 26498831
DOI: 10.1002/lary.25743