Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.10.008
Brazilian Journal of Anesthesiology
Case Report

Ultrasound-guided central venous access for patients in the Intensive Care Unit in prone position: report of three cases

Bruno Manuel Marques Lima, Linda Cheung

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Abstract

The prone position is extensively used to improve oxygenation in patients with severe acute respiratory distress syndrome caused by SARS-CoV-2 pneumonia. Occasionally, these patients exhibit cardiac and respiratory functions so severely compromised they cannot tolerate lying in the supine position, not even for the time required to insert a central venous catheter. The authors describe three cases of successful ultrasound-guided internal jugular vein cannulation in prone position. The alternative approach here described enables greater safety and well-being for the patient, reduces the number of episodes of decompensation, and risk of tracheal extubation and loss of in-situ vascular lines.

Keywords

Ultrasound;  Central venous catheter;  Internal jugular vein;  Prone position;  SARS-CoV-2 pneumonia;  Case report

References

1 C Guérin, J Reignier, JC Richard, et al. Prone positioning in severe acute respiratory distress syndrome N Engl J Med, 368 (2013), pp. 2159-2168

2 M Mittermaier, P Pickerodtc, F Kurth, et al. Evaluation of PEEP and prone positioning in early COVID-19 ARDS EClinicalMedicine, 28 (2020), Article 100579

3 GY Chen, KI Cheng, HT Hsu, YM. Lu Ultrasound-guided central venous catheterization in the prone position Br J Anaesth, 119 (2017), pp. 337-338

4 T Flament, J Mankikian, E. Mercier Ultrasound-guided insertion of dialysis catheter in the prone position Intensive Care Med, 40 (2014), p. 620

5 C Anez, A Becerra-Bolaños, A Vives-Lopez, A. Rodríguez-Pérez Cardiopulmonary resuscitation in the prone position in the operating room or in the intensive care unit: a systematic review Anesth Analg, 132 (2021), pp. 285-292

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Braz J Anesthesiol

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