Bên phải hay bên trái khi đặt CVP ?

 Ngoài việc lựa chọn vị trí đặt, loại đường dẫn và catheter thì việc thường sử dụng bên phải cũng gây ra thắc mắc cho các bs thực hành ls, vậy chúng ta cùng thử tìm hiểu một chút  nguyên do là từ đâu

Right internal jugular vein cannulation is generally preferred over the left due to the larger diameter of the right-sided vein, its more direct path to the superior vena cava, the lower dome of the right pleura, absence of the thoracic duct, and the relative ease of access for a right-handed operator [6]. 

https://pubmed.ncbi.nlm.nih.gov/16302239/

Right-sided access is also associated with a low rate of catheter malposition [4] and is commonly used in situations that require reliable catheter positioning for immediate use, such as drug administration or transvenous pacing. 
https://pubmed.ncbi.nlm.nih.gov/27555164/

Two single-center randomized trials found that cannulation of the left jugular vein is more time consuming and associated with a higher incidence of complications
https://pubmed.ncbi.nlm.nih.gov/7718748/
https://pubmed.ncbi.nlm.nih.gov/10818329/

However, a left-sided approach may be necessary for those with prior right-sided access, excessive scarring, vein thrombosis, or those with other indwelling central venous devices.