External jugular vein (EJV) cannulation is frequently used in intensive care units (ICUs) as an alternative vascular access in patients with difficult peripheral venous cannulation or when short-term administration of vasopressors, blood products, or hyperosmolar/vesicant drugs is required. Compared to central venous catheter (CVC) insertion, EJV cannulation is perceived to be less invasive and may avoid complications such as pneumothorax, arterial puncture, deep vein thrombosis, and central line–associated bloodstream infections (CLABSI). However, there is limited prospective data on the complication profile, optimal duration, and clinical outcomes of EJV cannulation in critically ill adults.

This prospective observational cohort study will be conducted over one year in the ICU of St. John’s Medical College Hospital. Adult ICU patients requiring EJV cannulation as per standard ICU protocol will be enrolled. EJV cannulation will be performed using landmark-guided or ultrasound-guided techniques under aseptic precautions by trained ICU personnel. Patients will be followed from the time of cannulation until 48 hours after catheter removal.

The study aims to determine the indications and complications associated with EJV cannulation. Secondary outcomes include assessment of CVC-free days and patient comfort with the EJV cannula in situ.

Data on demographics, indication for cannulation, procedural details, duration of cannula placement, daily local and systemic complications, microbiological outcomes, patient comfort scores, and need for subsequent CVC insertion will be collected. Ultrasound evaluation will be performed after catheter removal to detect delayed complications such as thrombosis. The findings of this study may help define the safety profile understanding, optimal dwell time, and clinical utility of EJV cannulation in ICU settings, particularly in resource-limited environments.