Abstract: Objective To systematically evaluate the safety and effectiveness of sitting position internal jugular vein catheterization (SP-IJVC) in patients with acute left heart failure (ALHF) and to compare SP-IJVC with traditional femoral vein catheterization (FVC).  Methods The patients with ALHF admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2020 to May 2024 were retrospectively divided into SP-IJVC group (n=17) and FVC group (n=20). The main outcome includes success rate of operation and incidence of complications, and the secondary outcome included patency period of the catheters and incidence of thrombosis. Python 3.8 was used for statistical analysis. Independent sample t-test was used for comparison of numerical data between groups, and Fisher's exact test or chi-square test was used for comparison of counting data between groups.  Results  A total of 37 patients were included in this study. In SP-IJVC group, the operation success rate was 100%, and the complication rate was 11.8% (2/17), lower than the rate of 25.0% (5/20) in FVC group (χ²=4.682, P=0.032); the average catheter patency period was 16.2±3.5 days, longer than the period of 10.8±2.1 days in FVC group (t=5.573, P＜0.001); the thrombosis rate was 5.9% (1/17), lower than the rate of 22.1% (4/18) in FVC group (χ²=4.021, P=0.045). Subgroup analysis of SP-IJVC group showed that the complication rate was 8.3% (1/12) in ultrasound-guided subgroup (n=12) and was 20.0% (1/5) in blind puncture subgroup (n=5), without statistically significant difference between the two groups (χ²=0.578, P=0.447); the operation time  was 8.5±2.1 minutes for posterior approach (n=11), shorter than the time of 11.2±3.4 minutes for anterior approach (n=6) (t=2.531, P=0.021).  Conclusion  SP-IJVC provides a safe and effective vascular access option for patients with ALHF who can't lie flat, and the catheter function and safety are superior to FVC method. We recommend SP-IJVC as the first choice for these ALHF patients.

Key words: nternal jugular vein catheterization, Acute left heart failure, Hemodialysis