Pitfalls in internal jugular vein cannulation

Abstract

Central venous catheter insertion in the internal jugular vein (IJV) is frequently performed in acute care settings, facilitated by its easy availability and increased use of ultrasound in healthcare settings. Despite the increased safety profile and insertion convenience, it has complications. Herein, we aim to inform readers about the existing literature on the plethora of complications with potentially disastrous consequences for patients undergoing IJV cannulation.

Keywords: Catheterization; Central venous; Complications; Thoracic duct; Arteriovenous fistula; Vocal cord paralysis; Pneumothorax; Cardiac tamponade

Core Tip: Central venous catheter placement is widely performed in healthcare settings, including critical care units, operating rooms, emergency departments, and patient-care wards. Although its safety profile has significantly increased with the routine use of ultrasound guidance, it is often associated with potential risks. The internal jugular vein remains the most preferred route for central venous cannulation. Potential complications can be due to anatomical variations or vascular, neural, pulmonary, cardiac, or lymphatic injuries, even with normal anatomy.