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To determine the optimal head position during ultrasound-guided internal jugular vein (IJV) cannulation, researchers in Italy randomized 1332 patients (mean age, 53) to IJV cannulation with head rotation at 0 degrees (neutral position) or 45 degrees. All patients were intubated, were undergoing major elective neurosurgical procedures, and required central venous access. Cannulations were performed by six anesthesiologists trained and experienced in ultrasound-guided IJV cannulation. Patients with coagulopathy and those aged <12 years were excluded.
Baseline patient characteristics were similar in the two groups. All IJV cannulations were successful. In both groups, mean time from ultrasound visualization of the target vein to aspiration of b…