Summary and Conclusions
The most constant superficial veins for transfusion are the saphenous, cephalic, and external jugular. Frequently the veins of the extremities are unsuitable for massive intra-operative transfusion. In addition, peripheral transfusions are often accompanied by venous spasm. The external jugular vein offers an admirable site for venipuncture and rapid transfusion. The vessel is large, thin-walled, and distensible. The jugular route has proved invaluable during emergency cardiovascular operations, but is indicated whenever massive transfusion is contemplated, or peripheral sites are not readily available. The jugular vein is also more accessible to the anaesthetist during the operative procedure than the saphenous or cephalic veins.
The external jugular may also be used for resuscitation preceding emergency operation, and for transfusion and fluid therapy postoperatively. Its use post-operatively is limited by the risk of air embolism and by the fact that many patients are emotionally disturbed by an infusion in this region. Possible complications are interstitial transfusion, cardiac failure from too-rapid transfusion, and venous air embolism.
Résumé
Les veines superficielles le plus souvent employées pour les transfusions sont les veines saphènes, jugulaires externes et céphaliques. Fréquemment, les veines des extrémités sont peu propices aux transfusions massives per-opératoires; de plus, elles sont souvent le siège de spasmes veineux. La veine jugulaire externe, à paroi mince et extensible, à large lumière, est le site idéal pour une vénisection et une transfusion rapide. Cette voie est excellente au cours des interventions cardiovasculaires urgentes; elle est aussi indiquée pour les transfusions massives où l’on ne peut trouver une voie périphérique. Elle est également plus accessible pour l’anesthésiste, au cours des interventions chirurgicales, que la saphène ou la céphalique. La veine jugulaire externe peut être utilisée en ressuscitation avant une opération d’urgence, ou post-opératoirement pour l’administration de transfusions et de solutés; mais, dans ce dernier cas, l’emploi en est limité à cause du danger d’embolie gazeuse et des troubles émotionnels que peuvent produire des perfusions à cet endroit.
Les complications possibles sont: la transfusion interstitielle, l’embolie gazeuse et la défaillance cardiaque lors de transfusions trop rapides.
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Keenleyside, H.B. External jugular vein for rapid transfusion during surgery. Can. Anaes. Soc. J. 9, 512–519 (1962). https://doi.org/10.1007/BF03019192
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DOI: https://doi.org/10.1007/BF03019192