Caudal Traction of the Arm Improves Supraclavicular Ultrasound Visualization of the Subclavian Vein

There is some evidence that a supraclavicular approach to subclavian vein cannulation with ultrasound guidance may be safer than the traditional landmark-based subclavian approach. Using an ultrasound probe placed above the clavicle, investigators in Korea measured the puncturable length of the subclavian vein and the available angle for needle insertion in 20 infants, 20 young children, and 20 adults undergoing general anesthesia. Measurements were taken with the ipsilateral arm in neutral, caudal traction, and abduction positions.

The length of puncturable subclavian vein and the available angle for needle insertion increased significantly with caudal traction compared with the neutral position (increases of 35.6% and 25.0%, respectively),…