Why the study?
Does head rotation (20 or 30 degrees) improve the success rate or reduce the number of attempts for Right Internal Jugular Vein cannulation compared to a neutral head position in patients undergoing open heart surgery?
Does head rotation (20 or 30 degrees) improve the success rate or reduce the number of attempts for Right Internal Jugular Vein cannulation compared to a neutral head position in patients undergoing open heart surgery?
Head rotation up to 20 degrees may be used to make landmarks prominent for RIJV cannulation, but extreme rotation (30 degrees) does not improve success and may increase complications.
Neutral position suffices for RIJV cannulation; challenges routine rotation and extends evidence favoring neutral head position in cardiac surgery.
The position of the head of the patient play an important role in the ease and success of Right Internal Jugular Vein (RIJV) cannulation using external landmark-guided technique. Sixty patients undergoing open heart surgery for both acquired and congenital heart diseases were studied in three groups-neutral head position, head rotated to 20 degree and head rotated to 30 degree to the left for RIJV cannulation. The overall success rate irrespective of number of attempts and head positions in this study was 93.3%. Complications were a bit higher than in other studies. Available literature did not compare between different degree of position of head rotation. This study compared between these groups in terms of number of attempts required for RIJV cannulation, but no significant difference was found between or within the groups (P>0.05). From this study it can be proposed that, some degree of rotation (upto 20 degree) may be allowed to make landmark prominent but extreme degree of rotation which result in more number of attempts and complications is not desired. Journal of BSA, Vol. 20, No. 2, July 2007 p.56-60
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Choudhury et al. (2009) studied this question.
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