• U K Teichgräber, T Benter, M Gebel, and M P Manns.
• Department of Gastroenterology and Hepatology, Hannover Medical School, Germany.
• AJR Am J Roentgenol. 1997 Sep 1;169(3):731-3.

ObjectiveThe internal jugular vein (IJV) is an important access to the central venous system. We compared sonographically guided technique with the traditional anatomic landmark technique for IJV catheterization.Subjects And MethodsIn a prospective randomized trial, 100 patients underwent routine catheterization of the IJV (50 patients in the sonography group and 50 patients in the anatomic landmark group). Access time, failure rates, and complication rates were evaluated. In addition, the physicians' number of years of experience with catheter insertion was recorded.ResultsAccess time was markedly shorter with the sonographically guided technique (mean, 15.2 sec; range, 8-76 sec) than with the anatomic landmark technique (mean, 51.4 sec; range, 3-820 sec) (p = .001). The failure rate was significantly lower with the sonographically guided technique (p = .002). Complications were fewer with the sonographically guided technique (neck hematoma, 2% versus 10%; plexus irritation, 4% versus 6%; carotid artery puncture, 0% versus 12%). We found that the number of years of postgraduate clinical training was greater in the group of physicians using the anatomic landmark technique.ConclusionThe sonographically guided technique is associated with less risk and less inconvenience for patients, especially critically ill patients, for whom the technique provides fast, safe, and easy IJV catheterization.

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