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Dynamic variation of the axillary veins due to intrathoracic pressure changes: A prospective sonographic study.

Boris TufegdzicAndrey KhozenkoTerrence Lee St JohnTimothy R SpencerMassimo Lamperti
Published in: The journal of vascular access (2019)
Anatomical variations in depth and diameter as well as the collapsibility due to intrathoracic pressures changes represent common challenges that face clinicians during central venous catheterization of the axillary vein. A noteworthy increase in vessel size as patients transition from spontaneous to mechanical ventilation may theoretically improve first-pass cannulation success with practitioners skilled in both ultrasound and procedure. As a result, placing a centrally inserted central catheter after the induction of anesthesia may be beneficial.
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