Complications of monitoring of jugular bulb venous saturation

Introduction

Neurological monitoring is very important to change the prognosis of a critical neurological patient. The jugular venous bulb saturation is extremely important to evaluate the consumption and delivery of oxygen.

Objective

To describe complications during insertion and the permanence period of a jugular venous bulb catheter.

Materials and methods

Prospective, observational study of 21 patients from June 2000 to September 2002 in an intensive care unit. All patients were monitored with an intracranial pressure device (ICP – CAMINO). The jugular venous line was cannulated independent of which side. The catheter flow was sustained by continuous saline infusion (rate, 3 ml/hour). The monitor used was VIGILANCE (Baxter). Complications were observed during insertion such as arterial puncture, bleeding, and misplacement; during catheter permanence, obstruction and infection (daily examination); after decanulation, thrombosis detected through Doppler, which was performed after 24 hours. All the catheter tips were sent to bacteriological examination.

Results

The meaning time of canulation was 5 days. The thrombosis rate detected by Doppler was 31.6% (without clinical compromise). The catheter obstruction rate was 15.8% and the infection rate 10.5%.

Conclusion

Strict control with Doppler examination is very important to warrant optimal flow. The catheter must be changed every 5 days in order to avoid infection.