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

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