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Journal of Cardiac Failure Apr 2022Few data are available on the use of internal jugular vein (IJV) ultrasound parameters to assess central venous pressure and clinical outcomes among patients with... (Review)
Review
BACKGROUND
Few data are available on the use of internal jugular vein (IJV) ultrasound parameters to assess central venous pressure and clinical outcomes among patients with suspected or confirmed heart failure (HF).
METHODS
We performed electronic searches on PubMed, The Cochrane Library, EMBASE, EBSCO, Web of Science, and CINAHL databases from the inception through January 9, 2021, to identify studies evaluating the accuracy and reliability of the IJV ultrasound parameters and exploring its correlation with central venous pressure and clinical outcomes in adult patients with suspected or confirmed acutely decompensated HF. The studies' report quality was assessed by Quality Assessment of Diagnostic Accuracy Studies-2 scale.
RESULTS
A total of 11 studies were eligible for final analysis (n = 1481 patients with HF). The studies were segregated into 3 groups: (1) the evaluation of patients presenting to the emergency department with dyspnea, (2) the evaluation of patients presenting to the HF clinic for follow-up, and (3) the evaluation of hospitalized patients with acutely decompensated HF or undergoing right heart catheterization. US parameters included IJV height, IJV diameter, IJV diameter ratio, IJV cross-sectional area, respiratory compressibility index, and compression compressibility index.
CONCLUSIONS
The findings of this systematic review suggest a significant role for ultrasound interrogation of the IJV in evaluation of patients in the emergency department presenting with dyspnea, in the outpatient clinic for poor clinical outcomes in HF, and in determining the timing of discharge for patients admitted with acutely decompensated HF. Further studies are warranted for testing the reliability of the reported ultrasound indices.
Topics: Adult; Catheterization, Central Venous; Dyspnea; Heart Failure; Humans; Jugular Veins; Reproducibility of Results
PubMed: 34419599
DOI: 10.1016/j.cardfail.2021.08.009 -
Journal of Magnetic Resonance Imaging :... Nov 2022
Topics: Healthy Volunteers; Humans; Jugular Veins; Magnetic Resonance Imaging; Multiple Sclerosis; Ultrasonography
PubMed: 35324051
DOI: 10.1002/jmri.28178 -
European Review For Medical and... Jun 2021Timely intervention is the key to the successful management of penetrating injuries to jugular veins; however, the optimal clinical management of these perforations and...
OBJECTIVE
Timely intervention is the key to the successful management of penetrating injuries to jugular veins; however, the optimal clinical management of these perforations and associated risk factors for mortality are not fully established. This study examined the trauma characteristics, vital signs, and in-hospital mortality in penetrating external and internal jugular vein injuries (PEJVI and PIJVI, respectively).
PATIENTS AND METHODS
In this National Trauma Data Bank database study on patients with penetrating jugular vein injuries (PJVIs), details pertaining to demographics, comorbidities, type of injury, mechanism and intent of injury, Injury Severity Score (ISS), vital signs, treatment, and outcome, were abstracted. Multivariate logistic regression was used to identify the risk factors of in-hospital mortality.
RESULTS
A total of 548 patients with PJVIs were included in the final analysis. Patients with PEJVI were more likely to have a self-inflicted injury (p<.001) than those with PIJVI. In both groups, hemorrhage control surgery was performed in almost 60% of the patients within 24 hrs. of the injury (p=.767). Systolic blood pressure (OR 0.99, 95% CI: 0.98-1.00, p=.043), Glasgow coma scale (OR 0.88, 95% CI: 0.81-0.95, p<.001), ISS (OR 1.10, 95% CI: 1.06-1.14, p<.001), and the firearm as a mechanism of injury (OR 2.85, 95% CI: 1.19-6.79, p=.018) were found to be independently associated with the risk of in-hospital mortality.
CONCLUSIONS
The injury severity, hemodynamic stability, comma scale, intent, and mechanism of injury differed significantly in PEJVI and PIJVI; however, the type of PJVI did not have an independent association with in-hospital mortality.
Topics: Adult; Databases, Factual; Female; Glasgow Coma Scale; Hospital Mortality; Humans; Injury Severity Score; Jugular Veins; Logistic Models; Male; Middle Aged; Risk Factors; Wounds and Injuries; Wounds, Penetrating
PubMed: 34227070
DOI: 10.26355/eurrev_202106_26144 -
World Neurosurgery Apr 2020At present, no consensus has been reached on the compartmental subdivision of the jugular foramen (JF), which can complicate surgical planning in this area and hinder... (Review)
Review
BACKGROUND
At present, no consensus has been reached on the compartmental subdivision of the jugular foramen (JF), which can complicate surgical planning in this area and hinder understanding of foraminal tumor growth patterns. The extradural neural axis compartment (EDNAC) might aid in producing a standardized model in the future. In the present review, we have summarized the models of JF compartmentalization and analyzed how sound they are anatomically.
METHODS
The present narrative review identified the key studies and supporting reports that had discussed, referenced, or first presented models of JF compartmentalization.
RESULTS
Three intraforaminal components serve as the basis for JF compartmentalization: the fibro-osseous bridge, neurovascular contents, and EDNAC. A total of 4 models have been proposed to date. These include the 2-part (bipartite) models by Hovelacque (1934) and Shapiro (1972) and the 3-part (tripartite) subdivisions by Katsuta (1997) and Bernard (2018).
CONCLUSIONS
The bipartite model has been criticized as being oversimplified and lacking surgical validity. However, support for this compartmentation has persisted despite the increasing popularity of the tripartite model. The 3-part subdivision of Bernard can be considered the most anatomically faithful model to date owing to the consideration of the dura and EDNAC. It is important that future studies consider the entire anatomy of the JF, which may generate an anatomically accurate and surgically applicable compartmental model.
Topics: Accessory Nerve; Cranial Sinuses; Dura Mater; Glossopharyngeal Nerve; Humans; Jugular Foramina; Jugular Veins; Models, Anatomic; Occipital Bone; Petrous Bone; Vagus Nerve
PubMed: 31926358
DOI: 10.1016/j.wneu.2019.12.178 -
Journal of Perioperative Practice May 2024Cannulation of a central vein is crucial in patients for hemodynamic management and when insertion of a peripheral line is not possible. The internal jugular vein is the... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
Cannulation of a central vein is crucial in patients for hemodynamic management and when insertion of a peripheral line is not possible. The internal jugular vein is the preferred access site; however, in the case of not being accessible, the second cannulation site of choice is still unclear. The study aimed to access the feasibility of external jugular vein cannulation versus internal jugular vein cannulation in terms of success, cannulation time, number of attempts and complications.
MATERIALS AND METHODS
In this prospective, randomised double-blinded study, 100 patients received 7Fr size triple-lumen central vein catheter either in the internal jugular vein (n = 50) or external jugular vein (n = 50) through the landmark technique as a part of anaesthetic care in the operation theatre. The number of attempts, cannulation time and incidence of complications in both the techniques were observed and recorded.
RESULTS
The success rate in internal jugular vein cannulation was 88%, while in the external jugular vein, it was 78% (p = 0.17). The external jugular vein cannulation was comparatively quicker in our study (p = 0.01). Similarly, elevated body mass index did not affect the success rate in the number of cannulations attempts in either group (p = 0.08). In terms of complications, the internal jugular vein group had a total of 20% and the external jugular vein group had 28% complications; however, the complications were more severe in the internal jugular vein group.
CONCLUSION
Anaesthetists should rethink alternate routes for the insertion of central vein cannulation. The external jugular cannulation route is one of them.
Topics: Humans; Jugular Veins; Catheterization, Central Venous; Prospective Studies; Female; Male; Middle Aged; Double-Blind Method; Adult; Aged; Anatomic Landmarks
PubMed: 36946178
DOI: 10.1177/17504589231154360 -
BMC Surgery Jul 2023Extracorporeal membrane oxygenation (ECMO) has been increasingly used for severe neonatal respiratory failure refractory to conventional treatments. This paper...
OBJECTIVE
Extracorporeal membrane oxygenation (ECMO) has been increasingly used for severe neonatal respiratory failure refractory to conventional treatments. This paper summarizes our operation experience of neonatal ECMO via cannulation of the internal jugular vein and carotid artery.
METHODS
The clinical data of 12 neonates with severe respiratory failure who underwent ECMO via the internal jugular vein and carotid artery in our hospital from January 2021 to October 2022 were collected.
RESULTS
All neonates were successfully operated on. The size of arterial intubation was 8 F, and the size of venous intubation was 10 F. The operation time was 29 (22-40) minutes. ECMO was successfully removed in 8 neonates. Surgeons successfully reconstructed the internal jugular vein and carotid artery of these neonates. Arterial blood flow was unobstructed in 5 patients, mild stenosis was present in 2 patients, and moderate stenosis was present in 1 patient. Venous blood flow was unobstructed in 6 patients, mild stenosis was present in 1 patient, and moderate stenosis was present in 1 patient. The complications were as follows: 1 case had poor neck incision healing after ECMO removal. No complications, such as incisional bleeding, incisional infection, catheter-related blood infection, cannulation accidentally pulling away, vascular laceration, thrombosis, cerebral haemorrhage, cerebral infarction, or haemolysis, occurred in any of the patients.
CONCLUSION
Cannulation of the internal jugular vein and carotid artery can quickly establish effective ECMO access for neonates with severe respiratory failure. Careful, skilled and delicate operation was essential. In addition, during the cannulation process, we should pay special attention to the position of cannulation, firm fixation and strict aseptic operation.
Topics: Infant, Newborn; Humans; Extracorporeal Membrane Oxygenation; Constriction, Pathologic; Catheterization; Jugular Veins; Respiratory Insufficiency
PubMed: 37415109
DOI: 10.1186/s12893-023-02094-4 -
Annals of Vascular Surgery Apr 2023Spontaneous jugular venous ectasia (SJVE) is characterized by dilation of the internal jugular vein (IJV) and external jugular vein. It is generally considered a benign... (Review)
Review
BACKGROUND
Spontaneous jugular venous ectasia (SJVE) is characterized by dilation of the internal jugular vein (IJV) and external jugular vein. It is generally considered a benign anomaly. There is no accepted categorization for this disorder.
METHODS
We conducted a case series study and a systematic review of available articles on SJVE to understand the main characteristics, clinicopathologic classifications, and therapeutic approaches.
RESULTS
From January 2001 to December 2021, 14 patients in our hospital were analyzed. A total of 110 original articles (295 cases/311 lesions) were included in the systematic review. We proposed a classification and categorized SJVE into 4 main types (type I-IV) plus one (type V) in which the specific ectasia was located around the jugular bulb at the IJV.
CONCLUSIONS
Conservative treatment is preferred for patients with type I (without thrombus) SJVE and asymptomatic patients who can be treated without anticoagulants. The therapeutic efficiency of surgery was high, and the best surgical modalities were chosen according to the type of SJVE.
Topics: Humans; Dilatation, Pathologic; Treatment Outcome; Vascular Diseases; Thrombosis; Subclavian Vein; Jugular Veins
PubMed: 36549477
DOI: 10.1016/j.avsg.2022.11.023 -
Annals of Plastic Surgery Dec 2023Damage to the vascular system resulting from radiotherapy and previous surgeries in patients with recurrent neck tumors has a negative impact on secondary...
BACKGROUND
Damage to the vascular system resulting from radiotherapy and previous surgeries in patients with recurrent neck tumors has a negative impact on secondary reconstructions. In this study, we describe a simple method for occlusion of the great vessels of the neck in patients with difficult access to recipient vessels for anastomosis.
METHODS
A 1 or 0 gauge silk ligature is placed at a circumference of 540 degrees around the vessel, holding the base of the suture with a fine hemostatic clamp exerting sufficient pressure to stop the blood flow in the vessel (internal carotid artery or internal jugular vein), to prepare the end-to-side anastomosis to the flap.
RESULTS
From 90 head a neck reconstructions for oncologic patients using microvascular flaps performed between April 2011 and April 2021, 8 of them (8.8%) were performed in patients with multiple previous surgeries and/or radiotherapy, with lesion of the arterial thyrolyngopharyngofacial trunk and secondary recipient veins, being the internal carotid and internal jugular the only available recipient vessels in the neck.
CONCLUSIONS
Occlusion of the great vessels of the neck with a thick silk at 540 degrees held by a hemostatic clamp at its base is a safe and reproducible method for occlusion of these vessels to perform end-to-side anastomosis in patients with difficult vascular access in the neck without increasing the risk of endothelial damage and thrombosis from the anastomosis.
Topics: Humans; Jugular Veins; Carotid Artery, Internal; Constriction; Neoplasm Recurrence, Local; Neck; Head and Neck Neoplasms; Anastomosis, Surgical; Hemostatics
PubMed: 38079317
DOI: 10.1097/SAP.0000000000003738 -
Scientific Reports Sep 2021This study aimed to evaluate the biocompatibility and patency of our newly developed titanium vascular anastomotic device (TVAD) in a pig jugular vein. TVAD was made of...
This study aimed to evaluate the biocompatibility and patency of our newly developed titanium vascular anastomotic device (TVAD) in a pig jugular vein. TVAD was made of commercially pure grade 2 titanium. The patency and anastomotic time were simultaneously confirmed in an ex-vivo system developed by the authors and in vivo using pig jugular veins. Five 8-month-old pigs, with body weights of 50-60 kg, underwent anastomosis of both jugular veins using the device. Graft patency was evaluated for 12 weeks by biplane angiography and sonography. All tissue biopsy samples were analysed by histology. In all 10 cases, the anastomosis was completed in < 5 min. The vessel lumen was not damaged, and the inner vessel wall was completely endothelialised at the anastomotic site. No foreign body reactions were observed at the vessel lumen, vessels, and outer vessel walls by histopathologic analysis. Patency and absence of leakage at the anastomotic site of the follow-up period were confirmed clearly by angiography and sonography. This preliminary animal study proved that our newly developed device is a very promising tool for intima-to-intima contact anastomosis. TVAD can be used as a feasible and safe medical tool for vessel anastomosis.
Topics: Anastomosis, Surgical; Animals; Blood Vessel Prosthesis Implantation; Jugular Veins; Materials Testing; Models, Animal; Swine; Titanium; Vascular Patency
PubMed: 34471219
DOI: 10.1038/s41598-021-97157-y -
Medical Ultrasonography Aug 2022
Topics: Carotid Arteries; Catheterization, Central Venous; Humans; Jugular Veins; Punctures
PubMed: 36047415
DOI: 10.11152/mu-3727