{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:02:06Z","timestamp":1789070526218,"version":"build-2803163510"},"reference-count":29,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,6,16]],"date-time":"2019-06-16T00:00:00Z","timestamp":1560643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The ultrasound-guided axillary vein is becoming a compulsory alternative vessel for central venous catheterization and the anatomical position offers several potential advantages over blind, subclavian vein techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine the degree of dynamic variation of the axillary vein size measured by ultrasound prior to the induction of general anesthesia and after starting controlled mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective, observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>One hundred ten patients undergoing elective surgery were enrolled and classified according to sex, age, and body mass index. Two-dimensional cross-sectional vein diameter, area, and mean flow velocity were performed using ultrasound on both the left and right axillary veins of each subject before and after induction of anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There was statistically significant evidence showing that the axillary vein area increases when patients are mechanically ventilated. When considering venous flow velocity as a primary outcome, velocity decreased after patients moved from spontaneous to mechanical ventilation (coefficient\u2009= \u22120.267), but this relationship failed to achieve statistical significance ( t\u2009=\u2009\u20131.355, p\u2009=\u20090.179).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Anatomical variations in depth and diameter as well as the collapsibility due to intrathoracic pressures changes represent common challenges that face clinicians during central venous catheterization of the axillary vein. A noteworthy increase in vessel size as patients transition from spontaneous to mechanical ventilation may theoretically improve first-pass cannulation success with practitioners skilled in both ultrasound and procedure. As a result, placing a centrally inserted central catheter after the induction of anesthesia may be beneficial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1129729819852204","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T02:01:35Z","timestamp":1560736895000},"page":"66-72","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Dynamic variation of the axillary veins due to intrathoracic pressure changes: A prospective sonographic study"],"prefix":"10.1177","volume":"21","author":[{"given":"Boris","family":"Tufegdzic","sequence":"first","affiliation":[{"name":"Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE"},{"name":"Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrey","family":"Khozenko","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence","family":"Lee St John","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3128-2034","authenticated-orcid":false,"given":"Timothy R","family":"Spencer","sequence":"additional","affiliation":[{"name":"Global Vascular Access, Scottsdale, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Lamperti","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,6,16]]},"reference":[{"key":"bibr1-1129729819852204","first-page":"CD006962","volume":"1","author":"Brass P","year":"2015","journal-title":"Cochrane Db Syst 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