Ultrasound-guided internal jugular venous cannulation in infants: a prospective comparison with the traditional palpation method.

Abstract:

BACKGROUND:Percutaneous cannulation of the internal jugular vein in infants is technically more difficult and carries a higher risk of carotid artery puncture than in older children and adults. In this prospective study, the authors tested their hypothesis that using an ultrasound scanner would increase the success of internal jugular cannulation and decrease the incidence of carotid artery puncture in infants. METHODS:After approval from the institutional review board and receipt of written informed parental consent, 95 infants scheduled for cardiac surgery were randomized prospectively into two groups. In the landmarks group, the patients' internal jugular veins were cannulated using the traditional method of palpation of carotid pulsation and identification of other anatomic landmarks. In the ultrasound group, cannulation was guided using an ultrasound scanner image. The cannulation time, number of attempts, success rate, and incidence of complications were compared for the two groups. RESULTS:There were no significant differences between the two groups with regard to weight, age, and American Society of Anesthesiologists physical status classification. The success rate was 100% in the ultrasound group, with no carotid artery punctures, and 77% in the landmarks group, with a 25% incidence of carotid artery punctures. Both differences were significant (P > 0.0004). The cannulation time was less, the number of attempts was fewer, and the failure rate was significantly lower in the ultrasound group than in the landmark group. CONCLUSION:Ultrasonographic localization of the internal jugular vein was superior to the landmarks technique in terms of overall success, speed, and decreased incidence of carotid artery puncture.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Verghese ST,McGill WA,Patel RI,Sell JE,Midgley FM,Ruttimann UE

doi

10.1097/00000542-199907000-00013

subject

Has Abstract

pub_date

1999-07-01 00:00:00

pages

71-7

issue

1

eissn

0003-3022

issn

1528-1175

journal_volume

91

pub_type

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