Practitioner experience, technique of choice do not affect IJV catheterization performance

In general, practitioner experience does not seem to significantly impact the clinical performance of needle insertion techniques during ultrasound-guided internal jugular vein (IJV) catheterization, a recent study has found.

However, more experienced practitioners using the Seldinger technique achieved successful catheterization more quickly.

The study included 308 patients scheduled for IJV catheterization. Participants were randomly assigned to one of four groups: catheterization by inexperienced practitioners using the Seldinger (IE-S; n=78) or modified Seldinger (IE-MS; n=76) techniques; or by experienced practitioners using the Seldinger (E-S; n=78) or modified Seldinger (E-MS; n=76) techniques.

Catheterization was overwhelmingly successful, with 97.4 percent (n=300) of patients achieving procedural success; the eight patients who had initial failures were eventually successfully catheterized at their left IJV.

All four patient groups required a median of 1 needling attempt until successful venous puncture, and the difference across the arms was not statistically significant.

Similarly, secondary outcome measures—the incidence of successful catheterization within three attempts, the type of venous puncture, and the number of guidewire and catheter insertion attempts—were comparable across all four experience and technique groups.

On the other hand, among experienced practitioners, using the Seldinger technique vs its modified version led to a significantly shorter time to successful catheterization (101 vs 130 seconds; p<0.001). Technique had no such impact among inexperienced practitioners.