LONG- VERSUS SHORT-AXIS ULTRASOUND GUIDANCE FOR SUBCLAVIAN VEIN CANNULATION

AIM. The aim of this study was to compare the short and long axis approaches to ultrasound guided subclavian vein cannulation with respect to indicators of success. METHODS. Patients (n = 46) undergoing cardiac surgery and requiring central venous cannulation were randomised to undergo either long- or short-axis ultrasound-guided cannulation of the subclavian vein by a skilled anesthesiologist. First pass success, number of needle passes, procedural taken and complications were documented for each procedure. RESULTS. The subclavian vein was successfully cannulated in all 46 patients. The first pass success rate was higher in the short axis group 86 % compared to the long axis group 56 % [24:28 (86 %) versus 10:18 (56 %) p = 0.043]. Procedural time was significantly lower in the short axis (1.44 ± 1.11 versus 3.00 ± 2.01 min p = 0.002). Fewer needle redirections were required in the short axis group (0.14 ± 0.36 versus 1.11 ± 1.13 p = 0.008). CONCLUSIONS. The short-axis procedure was associated with a higher first pass success rate, shorter procedure time and fewer needle redirections. A short-axis procedure for ultrasound-guided subclavian cannulation offers advantages over long-axis procedure.