Internal Jugular Venous Cannulation Research Articles

Comparison of Ultrasound Versus Non Ultrasound based Techniques for Internal Jugular Venous Cannulation in Cardiac Surgical Patients: A Prospective Randomised Controlled Trial

Comparison of Ultrasound Versus Non Ultrasound based Techniques for Internal Jugular Venous Cannulation in Cardiac Surgical Patients: A Prospective Randomised Controlled Trial

Ease of Internal Jugular Venous Cannulation by Anterior V/S Posterior Approach: A Randomized Interventional Study

Background: Percutaneous cervical central venous cannulation is now common practice during Perioperative care in major surgical procedures, critically ill patients in intensive care units for long term hyperalimentation and for rapid restoration of blood volume in cases of acute blood loss. Proper route of insertion is essential for its success. The objective of this study is to compare procedural parameters and complications associated with anterior and posterior approaches for Internal Jugular Venous cannulation.
 Methods: Our study was conducted as a prospective randomized interventional trail in 60 patients undergoing scheduled cardiac surgeries requiring Right internal jugular venous cannulation in a tertiary level hospital after obtaining clearance from ethics committee, patients were randomly allocated into two groups either Anterior approach (Group A; n=30) or Posterior Approach (Group B; n=30). Number of attempts, time for identification of IJV, duration of cannulation, ease of insertion, complications were compared in both the groups.
 Results: The number of attempts (p value 0.036), mean time taken for vein identification (p value 0.0003), catheterization time (p value <0.001), incidence of arterial puncture and hematoma are less with posterior approach, ease of threading is comparable among both the group. There were no statistically significant intergroup differences with respect to the Age, Sex, ASA grade.
 Conclusion: The posterior approach is better than anterior approach for Internal Jugular Vein Cannulation, as it improves the success rate, permits easy threading of catheter, reduces access time and duration of cannulation, complications like arterial puncture, hematoma, pneumothorax are lesser in posterior approach.

Comparison of conventional needle holding technique and pen holding method of needle holding for real-time ultrasound-guided internal jugular venous cannulation - A randomised parallel-group study.

Ultrasound-guided central venous (CV) cannulation is the standard of care for inserting CV catheter in the right internal jugular vein (RIJV). However, mechanical complications can still occur. The primary objective of this study was to compare the incidence of posterior vessel wall puncture (PVWP) using conventional needle holding technique with pen holding method of needle holding technique for IJV cannulation. Secondary objectives were comparison of other mechanical complications, access time and ease of the procedure. This prospective, randomised parallel-group study included 90 patients. Patients requiring ultrasound-guided RIJV cannulation under general anaesthesia were randomised into two groups P (n = 45) and C (n = 45). In group C, the RIJV was cannulated using the conventional needle holding technique. In group P, the pen holding method of needle holding technique was used. Incidence of PVWP, complications (arterial puncture, haematoma) number of attempts for successful cannulation, time to insertion of guidewire and performer's ease were compared. The data were analysed using Statistical Package for the Social Sciences (SPSS version 24.0). A P value less than 0.05 was considered statistically significant. In our study, there was no significant difference in incidence of PVWP and complications between the two groups. Number of attempts and time for successful guidewire insertion were comparable. Ease of the procedure was scored a median of 10 in both the groups. There was no significant difference in the incidence of PVWP between the two techniques in this study, necessitating further evaluation of this novel technique.

COMPARISON OF ULTRASOUND GUIDED OUT OF PLANE SHORT AXIS METHOD / IN PLANE LONG AXIS METHOD FOR RIGHT INTERNAL JUGULAR VENOUS CANNULATION IN TERTIARY CARE HOSPITAL.

Background Ultrasound (US) guidance for Internal Jugular Venous (IJV) placement is considered gold standard in localization and cannulation, making the procedure safer with less complications. To compare the Aims & Objectives short-axis/out-of-plane (SAX) with the long-axis/in-plane (LAX) technique for US-guided CVC insertion in internal jugular vein in intensive care practice in terms of safety and efcacy. In this Retrospective observa Methods tional study we have enrolled total 232 patients admitted in our tertiary care hospital during June 2016 to June 2020 at NHLMMC, VS & SVP hospital, Ahmedabad, India after taking written informed consent and explaining the procedure to patient & their relatives. Randomisation was done at time of procedure by odd & even numbers put in opaque sealed envelope. There were two groups: Group S which included 116 patients in whom the out of plane short axis SAX technique was performed and Group L which also included 116 patients in whom the in plane LAX technique was performed for US-guided IJV insertion in Right internal jugular vein. The primary outcome was rst-attempt success rate of both the approaches for US-guided vascular catheterization. The secondary outcomes were total success rate, which was dened as successful venous cannulation without complication; cannulation time calculated in seconds; the number of attempts and complications (hematoma and arterial puncture). US-guided venous cannulation was Results successful without complications in 99% patients in group S & 95% in group L. Venous access time, cannulation time, and US imaging time were signicantly lower in the group S than in the group L (P<0.05). Complications in both groups had no statistically signicant difference. Hematoma formation was evident in one patient in group L. Multiple puncture was more in LAX group with no signicant difference. Conclusion: Out of plane SAX approach is better than in plane LAX approach for ultrasound guided IJV cannulation.

Optimal positioning of right internal jugular venous catheter: A randomised study comparing modified Peres' height formula and distance between insertion point and right third intercostal space.

ABSTRACTBackground and Aims:The position of the tip of the central venous catheter (CVC) is important to minimise complications. The aim of our study was to compare modified Peres’ height formula and landmark method using distance between puncture site and right third intercostal space (PS-RTICS) and to develop a reliable formula for correct positioning of tip of the CVC.Methods:This prospective, randomised study was conducted on 400 patients of either gender, of age 18 years and older, scheduled to undergo right internal jugular venous cannulation. Depending on the technique used for deciding the length of CVC to be inserted, the patients were randomly allocated into two groups: Group A, using modified Peres’ height formula, that is, height of patient (cm)/10-2 and Group B, using distance between PS-RTICS and subtracting one from it, that is (PS-RTICS)-1. The carina was taken as the landmark for optimum insertion of CVC, which was confirmed on postprocedure chest X-ray. Data so obtained were tabulated and analysed. P<.05 was considered statistically significant for correlation and regression coefficients.Results:In group A, the mean length of catheter inserted was 15.18 ± 0.73 cm and the catheter tip was found to be 2.41 ± 0.85 cm distal to carina (P =0.001). Over-insertion was found in 98.45% patients in group A. In group B, the mean length of catheter inserted was 14.12 ± 0.85 cm and the catheter tip was found to be 0.20 ± 1.18 cm distal to carina.Conclusion:Though both landmark and modified Peres’ height formula has low accuracy, landmark technique is superior in predicting correct depth of right internal jugular venous cannulation catheter.

Pediatric Horner’s syndrome secondary to internal jugular venous cannulation: case report

Pediatric Horner’s syndrome secondary to internal jugular venous cannulation: case report

Pediatric Horner’s syndrome secondary to internal jugular venous cannulation: case report

Horner’s syndrome, a disorder associated with ipsilateral damage to the sympathetic pathway, is a rare complication of cannulation into the internal jugular vein. Depending on the intensity of the injury and location, the damage may be irreversible, even in young children.

A Comparison between Ultrasound-guided Short-axis Approach and Oblique Axis Approach for Internal Jugular Venous Cannulation in the Emergency Department.

Background:Central venous catheter (CVC) placement is a frequently performed procedure in the emergency department (ED). We aim to compare two different ultrasound (US)-guided techniques, the short-axis (SAX) approach and the oblique axis (OAX) approach for the insertion of internal jugular vein (IJV) catheters in an ED setting.Methods:This prospective, observational study was conducted in the ED of a single tertiary care teaching hospital on patients requiring IJV cannulation. CVC placement was done using both the SAX and OAX approaches as per the ED physician's discretion. Outcome measures included acute complications, successful insertion of an IJV catheter, number of attempts, and access times. The Chi-square test was used to compare the study variables (acute complications, number of cannulation attempts, and successful cannulation) between the two approaches. Mann–Whitney U-test was applied to compare the mean differences of flash time and cannulation time.Results:Sixty patients were enrolled, of which 30 underwent IJV cannulation by the SAX technique and 30 by the OAX technique. We noted a total of 22 acute complications, 56.7% in the SAX group and 16.7% in the OAX group. A significant incidence of posterior venous wall puncture was noted in the SAX group (50.0%). No significant statistical differences were noted on analysis of other outcome measures.Conclusion:The OAX approach is a useful alternative technique to IJV cannulation in the ED setting. Further multicentric studies in this domain will be required to consider this technique as the primary approach to US-guided IJV cannulation in the ED setting.

Comparison of three different techniques for internal jugular vein cannulation under real time ultrasound guidance

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ultrasound (USG) guided Internal jugular venous (IJV) cannulation is preferred than traditional approach due to increase in success rate, reduction in time taken and attempts of successful cannulation and less complications. The purpose of our study was to observe and compare three different real time 2-dimensional US-guided approaches and to determine which approach improves rate of successful cannulation, decreases complications along with shorter average time taken for the procedure. Primary outcomes of the study were venous access time, catheterization time and success rate. Secondary outcomes were number of patients requiring second attempt and complications observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;120 adult patients were randomly divided into three groups according to real time US guided cannulation done with SAX-OP approach, LAX-IP approach and OAX-IP approach. Parameters like venous access time, catheterization time, number of patients requiring second attempt and complications were noted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Venous access time was shortest in LAX group 21.84±3.67 seconds which was just significant statistically. Catheterization time was shortest in LAX group 241±123 seconds. Cannulation success rate was highest in LAX group 98% and was statistically significant. Patients requiring second attempt was least in LAX group 2.5%. Posterior IJV wall puncture was observed in 10% patients in SAX group and none in LAX and OAX group which was statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; LAX-IP showed better performance in terms of higher cannulation success, lesser average venous access time and catheterization time and lesser complications. On toggling USG probe, both IJV and carotid artery can be differentiated and carotid puncture could be avoided. Hence LAX approach is safer and effective approach.&lt;/p&gt;

In-line oblique transducer approach for ultrasound guided cannulation of internal jugular vein.

Objective: To determine the frequency of successful cannulation of ultrasound assisted inline oblique transducer approach for internal jugular venous cannulation. Study Design: Descriptive Case Series. Setting: Department of Anesthesia and Intensive Care, Hameed Latif Hospital, Lahore. Period: 22-02-2017 to 22-08-2017. Material &amp; Methods: In this study the cases were included of both gender and age between 18 to 65 years. Jugular vein was visualized ultrasonographically in an oblique axis and the needle was inserted in the same plane, aligned with the longitudinal axis of the transducer. Success rate was noted. Results: The mean age of patients was 49.94±10.90 years, male to female ratio of the patients was 1.9:1. In this study the successful cannulation was observed in 145/155 (93.55%) patients. Conclusion: It has been observed in this study that the ultrasound assisted inline oblique transducer approach is successful technique for IJV cannulation.

Comparison of Three Ultrasound Views for Internal Jugular Venous Cannulation in Patients Undergoing Cardiac Surgery: A Randomized Trial.

Background:The quality of needle visualization during ultrasound-guided internal jugular vein (IJV) cannulation determines the ease of procedure, whereas posterior IJV wall puncture is the most common risk associated. The IJV can be imaged in different views, which offer certain advantages over each other. We compared three different ultrasound views for IJV cannulation short axis (SAX), long axis (LAX), and oblique axis (OAX) with respect to the quality of needle visualization, first pass success rate, and posterior IJV wall puncture.Methods:Two hundred ten patients undergoing elective cardiac surgery were analyzed in this prospective randomized clinical trial. Patients were randomly assigned to one of the three groups: SAX (n = 70), LAX (n = 70), and OAX (n = 70). The quality of needle visualization, first pass success rate, and incidence of posterior IJV wall puncture in each of the three ultrasound views were studied. The Chi-square test and ANOVA were used for the comparison of means and proportion between the groups.Results:The quality of needle visualization was graded as good in 90% patients in OAX group, 81.4% patients in LAX group, and 14.2% patients in SAX group, respectively (P < 0.0001). OAX group had the highest first pass success rate (94.2%) followed by SAX (88.5%), and then, LAX (82.8%), but it was statistically insignificant among the groups (P = 0.105). The mean IJV access time was longer in LAX group when compared to OAX and SAX group (P < 0.0001).The incidence of IJV posterior wall puncture was 14.2% patients in SAX group and none in other groups (P = 0.0011).Conclusion:The results suggest that OAX view can be adopted as standard approach during ultrasound-guided IJV cannulation as it safe and reliable.

Comparison of external jugular vein-based surface landmark approach and ultrasound-guided approach for internal jugular venous cannulation: A randomised crossover clinical trial.

Historically, landmark techniques for central venous access through the internal jugular vein (IJV) have yielded a lesser success rate and higher complication rate than the ultrasound (US)-guided approach. The purpose of this study is to assess the success and safety of a novel external jugular vein (EJV)-based landmark (EJV-LM) approach compared with the real-time US-guided approach for central venous access through the IJV. This was a prospective, randomised, crossover trial performed in patients during elective cardiac and non-cardiac surgery. Each resident randomly inserted a central venous catheter using EJV-LM approach and real-time US-guided approach. The primary outcome was first-attempt success. Secondary outcomes included overall success rate, number of puncture attempts, cannulation time, haematoma and mechanical complications. A total of 188 patients were randomly assigned to the EJV-LM and US groups. The demographic characteristics of the groups were comparable. The first-attempt success was not different between EJV-LM and US-guided techniques (79.8%; [95% CI: 70.2-87.4] vs 89.4% [95% CI 81.3-94.8]; P=.06). The overall success rate was 100% with both techniques. There were no differences in the number of puncture attempts with introducer needle (1[1-3] vs 1[1-2]; P=.07). Cannulation time was longer in the EJV-LM group compared with the US group (58.11±6.6 vs 44.27±5.28seconds; P=.0001). EJV-LM technique was associated with a higher occurrence of overall complications compared with the US technique (12.8% [95% CI: 6.7- 21.2] vs 4.2% [95% CI: 1.1-10.5]; P=.03). No major mechanical complications were observed with either techniques. In patients with non-distorted neck anatomy and a visible EJV, IJV catheterisation using the EJV-based LM approach and standard US-guided technique yielded similar first-attempt and overall success rates. Cannulation time was longer and complications occurred more frequently in the EJV-based LM compared with the standard US-guided technique.

The application of human reliability analysis to three critical care procedures

BackgroundProcedures carried out in the intensive care unit are prone to human error. Standardisation has been suggested as an approach for reducing errors. This study used human reliability analysis methodologies to examine commonly performed critical care procedures: endotracheal suctioning; ultrasound-guided right internal jugular vein cannulation; and rapid-sequence intubation. MethodsThe subgoals, or individual steps, required to complete the three procedures were identified using hierarchical task analysis. The systematic human error reduction and prediction approach was then used to identify potential human errors at each subgoal, the level of risk and how these potential errors could be prevented. ResultsEndotracheal suctioning procedure was broken down into 129 subgoals, of which 49 (38.0%) were high-risk. Ultrasound-guided right internal jugular venous cannulation was divided into 224 subgoals, of which 131 (58.4%) were medium-risk, and 20 (8.9%) were identified as high-risk. Rapid sequence intubation was divided into 167 subgoals. A total of 73 (43.7%) of these subgoals were judged to be high-risk. ConclusionsThe use of human reliability analysis techniques can support healthcare professionals to gain an in-depth understanding of how particular procedures are carried out in order to reduce the risk of, and improve training in, how to perform these procedures.

Comparative analysis of mechanical complications of emergency versus planned ultrasound-guided internal jugular venous (IJV) cannulation: data from the emergency room of a third-level hospital in Quito, Ecuador

Background: Central venous catheters (CVC’s) are useful tools for the treatment of critically ill patients, especially in the emergency room, and are recognized for decreasing rates of failure and mechanical complications. Certain parameters can act as predictors to determine the likelihood of this type of complication. The aim of this study is to determine the incidence and predictors of mechanical complications using internal jugular venous (IJV) cannulation, especially when considering planned versus emergency cannulation. Methods: A prospective, observational study was performed at Hospital de los Valles, Quito, Ecuador, during a three-year period. All patients who presented to the emergency room with an indication for IJV cannulation and with no potential contraindications were included. Demographic, safety and procedure related data were collected. Variables were analyzed using STATA, and p-values &lt;0.05 were considered significant. Results: A total of 142 patients were included. The majority of procedures (64%) were planned. The main indication for CVC placement via IJV cannulation was chronic renal failure (54%), all of which were planned procedures, followed by sepsis (15%), where most procedures (91%) were emergencies. The IJV was anatomically located lateral to the carotid artery in 38.73% of cases. Mechanical/technical complications were reported in 13 patients. Cannulation time greater than two minutes was found to be the only factor independently associated with a higher probability (12.4 times) of developing mechanical/technical complications. The vessel location did not affect the incidence of complications either in emergency or planned procedures when using ultrasound. Conclusions: Ultrasound-guided IJV cannulation is a safe technique that can be performed as an emergency or planned procedure without increased complication rates in the emergency room. Additionally, a puncture time of less than two minutes is associated with the safest profile in this patient population.

Computer-assisted needle navigation for pediatric internal jugular central venous cannulation: A feasibility study.

Vascular access for central venous catheter placement is technically challenging in children. Ultrasound guidance is recommended for pediatric central venous catheter placement, yet many practitioners rely on imprecise anatomic landmark techniques risking procedure failure due to difficulty mastering ultrasound guidance. A novel navigation system provides a visual overlay on real-time ultrasound images to depict needle trajectory and tip location during cannulation. We report the first pediatric study assessing feasibility and preliminary safety of using a computer-assisted needle navigation system to aid in central venous access. A prospective, institutional review board-approved feasibility study was performed. All participants provided written informed consent. Ten patients (mean age: 11.4 years, five males) underwent central venous catheter placement with ultrasound and navigation system guidance. All procedures were performed by interventional radiologists expert in vascular access. Feasibility was measured through binary (yes/no) responses from participating users assessing device usability and feasibility. The number of needle passes and procedure time measures were also recorded. Internal jugular veins (seven right sided, three left sided) were cannulated in all patients with no complications. Users confirmed navigation system feasibility in all 10 participants. Mean vein diameter and depth was 13.3 × 9.8 ± 3.4 × 2.1 and 7.0 ± 1.7 mm, respectively. Successful cannulation occurred in all patients and required only a single needle pass in 9 of 10 patients. Mean device set-up and vascular access times were 5:31 ± 2:28 and 1:48 ± 2:35 min, respectively. This pilot study suggests that it is feasible to use a novel computer-assisted needle navigation system to safely obtain central venous access under ultrasound guidance in pediatric patients.

A prospective randomized control trial of ultrasound guided internal jugular venous cannulation: The short versus the long axis approach.

Objectives: To compare the first pass success rate between long and short axis approaches in ultrasound guided IJV cannulation. Study Design: Prospective randomized controlled study. Setting: Department of Anesthesia and Intensive Care, Jinnah Hospital, Lahore. Period: Between 3rd Mar, 2016 to 2nd Sep, 2016. Material &amp; Method: One hundred and ten patients admitted in the ICU were included in this study. Internal jugular vein was visualized ultrasonographically. In group A patients, long-axis view was used, while in group B patients, short-axis view was used to pass the needle. Under aseptic measures, US probe was placed on the neck and IJV viewed with either approach. During needle advancement if the needle penetrates the vein in the first attempt and blood flush-back is viewed, it was labeled as 1st pass success. This first pass success rate was noted. Results: One hundred and ten patients (55 in each group) were included in the study. The mean age of the patients was found to be 33.89 ± 13.35 years in group A and 35.90 ± 14.10 years in group B. The primary outcome of the study was to compare 1st pass success rate in both groups. The first pass success rate was 74.5% in group B (short-axis) and 61.8% in group A (long-axis); independent sample test showed non-significant (P=0.219). There is no difference in the frequency of 1st pass success rate in short axis approach and long axis approach for Ultrasound-guided IJV cannulation. Conclusion: Ultrasound-guided internal jugular venous cannulation with both approaches i.e. short-axis view and long-axis view have no significant difference in terms of first pass and therefore are equally successful.

Treatment of inadvertent subclavian artery cannulation with a percutaneous vascular closure device

Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization. We report a case of accidental subclavian artery catheterization close to the vertebral artery during internal jugular venous cannulation, which was successfully managed in the interventional suite with catheter removal and use of a vascular closure device.

Ultrasound-guided central venous vascular access-novel needle navigation technology compared with conventional method: A randomized study.

Central venous catheter insertion is a common procedure in the intensive care setting. However, complications persist despite real-time ultrasound guidance. Recent innovation in needle navigation technology using guided positioning system enables the clinician to visualize the needle's real-time position and trajectory as it approaches the target. We hypothesized that the guided positioning system would improve performance time in central venous catheter insertion. A prospective randomized study was conducted in a single-center adult intensive care unit. In total, 100 patients were randomized into two groups. These patients underwent internal jugular vein central venous catheter cannulation with ultrasound guidance (short-axis scan, out-of-plane needling approach) in which one group adopted conventional method, while the other group was aided with the guided positioning system. Outcomes were measured by procedural efficacy (success rate, number of attempts, time to successful cannulation), complications, level of operators' experience, and their satisfaction. All patients had successful cannulation on the first attempt except for one case in the conventional group. The median performance time for the guided positioning system method was longer (25.5 vs 15.5 s; p = 0.01). And 86% of the operators had more than 3-year experience in anesthesia. One post-insertion hematoma occurred in the conventional group. Only 88% of the operators using the guided positioning system method were satisfied compared to 100% in the conventional group. Ultrasound-guided central venous catheter insertion via internal jugular vein was a safe procedure in both conventional and guided positioning system methods. The guided positioning system did not confer additional benefit but was associated with slower performance time and lower satisfaction level among the experienced operators.

Internal Jugular Vein Catheterization: The Landmark Technique versus Ultrasonography Guidance in Cardiac Surgery.

BackgroundCentral venous catheterization is an invasive procedure that must be performed during cardiovascular surgery. The addition of ultrasound guidance to the catheterization technique has shown effectiveness in reducing complications because it allows for the visualization of anatomical variations prior to intervention and the continual visualization of the needle during the placement. The purpose of this study was to evaluate the effectiveness of needle-guiding ultrasound for internal jugular venous cannulation.MethodPatients undergoing coronary bypass surgery at Hitit University, department of cardiovascular surgery, from January 2014 to June 2018, were included in the study. The patients were divided into two groups: those with catheterization with ultrasound guidance (Group U) and those with catheterization performed with the anatomic landmark technique (Group L).ResultsA total of 584 cases were investigated. The success of the procedure and complication rates for both methods were compared. Central vein catheterization with ultrasonography produced success and complication rates significantly better than those for catheterization using the landmark technique (p=0.04 and p=0.00001, respectively).ConclusionThis study demonstrated that the use of ultrasonography for internal jugular vein catheterization for patients undergoing coronary bypass surgery significantly reduced the complication rates as compared to those of patients where the landmark technique was used for catheterization.

Clinical efficacy of portable probe sterile film used for ultrasound-guided central venous cannulation

Objective To evaluate the clinical efficacy of portable probe sterile film used for ultrasound-guided central venous cannulation. Methods One hundred emergency patients of both sexes with lower extremity fractures prepared for ultrasound-guided right internal jugular venous cannulation, aged 18-60 yr, weighing 50-85 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups (n=50 each) by using a random number table: portable probe sterile film group (group P) and sterile glove group (group G). In group P, the ultrasound probe was placed in the portable probe sterile film, and then the sealed film was adhered to the scanning surface without fold or bubble after emptying gas by syringe.In group G, the ultrasound probe was wrapped by disposable medical sterile gloves with the scanning surface coated by coupling agents.The microbiological detection of probe was performed after aseptic processing, and relative sterility was defined as the total number of colonies less than or equal to 5 cfu/cm2.The probe aseptic processing time, puncture and cannulation time and total operation time were recorded.The aseptic qualification of scanning surface and handle was recorded.The clarity (equal to 3 point) of ultrasonic image was assessed and recorded using a 4-point scale.The success of first puncture, first cannulation and total cannulation was recorded.Complications such as bleeding, hematoma and dyspnea were observed simultaneously. Results The aseptic qualification rate of scanning surface was all 100% in both groups.Compared with group G, the probe aseptic processing time was significantly prolonged, the puncture and cannulation time and total operation time were shortened, the aseptic qualification rate of handle was increased, and the clarity rate of ultrasonic image and success rates of first cannulation and total cannulation were all increased, the incidence of bleeding and hematoma was decreased (P 0.05). Conclusion The portable probe sterile film is easy to operate, easy to realize an aseptic condition, has limited influence on the ultrasonic imaging, also can assure successful cannulation and reduce complications, so it is suitable for aseptic processing when used for ultrasound-guided central venous cannulation. Key words: Ultrasonography; Catheterization, central venous; Sterilization