Internal jugular vein diameter in pediatric patients: are the J‐shaped guidewire diameters bigger than internal jugular vein? An evaluation with ultrasound

Sayın, Murat; Mercan, Arzu; Köner, Özge; Türe, Hatice; Celebi, Suheda; Sözübir, Selami; Aykaç, Bora

doi:10.1111/j.1460-9592.2008.02631.x

Cited by 36 publications

(25 citation statements)

References 18 publications

(38 reference statements)

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“…Regarding the diameter of central venous vessels, it was demonstrated in pediatric patients (1 month and older) (Sayin et al,2008), and also confirmed by our study, that the diameter of the internal jugular vein is smaller than the diameter of the J‐tip guidewire curve. The J‐tip of the guidewire of a 4‐F catheterization kit has a diameter of 5.0 mm.…”

Section: Discussionsupporting

confidence: 90%

Topographical anatomy of central venous system in extremely low‐birth weight neonates less than 1000 grams and the effect of central venous catheter placement

et al. 2011

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Central venous catheterization is widely used in neonatology. Although ultrasonic guidance for central venous catheter placement is available, complications occur significantly more frequently in infants, especially neonates, than in adults. This study seeks to determine the characteristics, topographical conditions, regional relationships, and diameters of the venous structures of the upper extremity and the thoracic central venous system in extremely small preterm neonates (mean: 900 g). Nine formaldehyde-fixed preterm stillborns were prepared (mean 27 2/7 weeks' gestational age). The anatomical preparation involved the complete thoracic wall, neck and shoulder region, and preparation of the upper extremities. It was shown that the course of the internal jugular vein can be influenced by rotation of the head. Maximum head rotation (80°) to the contralateral side leads the internal jugular vein to overlap the common carotid artery and sharpens the confluence angle of the internal jugular into the brachiocephalic vein. We propose that this has the potential to result in dislocation of the catheter. Less rotation of the head (<30°) is favorable as the internal jugular vein and common carotid artery run in parallel. Commonly used central venous catheters (2F-4F) may not occlude the vascular lumen completely. Small central venous cannulation using a single-orifice catheter through arm veins (1F) may also not occlude peripheral vessels of the upper extremity (cephalic and basilic veins). The right internal jugular vein has a straight course, appears suitable for central venous access and less hazardous, especially when using stiff catheters. The use of small straight wire guides is recommended.

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Section: Discussionsupporting

confidence: 90%

Topographical anatomy of central venous system in extremely low‐birth weight neonates less than 1000 grams and the effect of central venous catheter placement

et al. 2011

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“…In order to avoid the risk of venous thrombosis, this panel suggests that the external diameter of the catheter should not exceed 1/3 of the internal diameter of the vein. Similar measurements can avoid the insertion of a J-wire guide that is larger than the vessel [58]. Further research is required to compare both the mechanical and infectious complications for different access sites in neonates and children.…”

Section: Integration In Clinical Practicementioning

confidence: 99%

International evidence-based recommendations on ultrasound-guided vascular access

Lamperti¹,

et al. 2012

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“…The use of LM technique to insert CVA requires multiple trials maneuver can lead to hematoma formation that might induce changes in IJV or might even cause external compression, which makes its access more difficult even when US locations is used as rescue techniques [16].…”

Section: Discussionmentioning

confidence: 99%

“…The small diameter of IJV in low birth weight neonates to the age and the weight makes its success more difficult than in adults. The smaller dimensions of the IJV in infants increase the number of attempts, favor the changes in puncture points and the depth of needle insertion, and finally increase the risks of complications including carotid artery injury or pneumothorax [16].…”

Section: Discussionmentioning

confidence: 99%

Surgical insertion of central venous catheters in low-birth-weight neonates

Khirallah¹,

batarny²,

Elsharaby³

2015

Annals of Pediatric Surgery

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Aim: Neonatal central vascular access (CVA) represents a daily practice in neonatal intensive care unit. Low birth weight (LBW) neonates pose a challenge to anesthetists who try the landmark technique to cannulate central veins. We reported our experience of open surgical cutdown (OSC) to insert catheters through right internal jugular vein (IJV) and assessed feasibility, operative time, durability of line, and postoperative complications of this technique.Methods: A total of 660 LBW neonates needed CVA and underwent OSC of right IJV because of medical and surgical indications. We reported operative time, whether anesthesia or sedation, whether in the theater or at the bedside, difficulties, complications and duration of line, and causes of failure. Transverse neck incision was made 1 cm above the medial third of the clavicle, right IJV was identified, venotomy was performed, and catheter was inserted.Results: A total of 660 LBW neonates had CVA in right IJV, ligation of vein occurred in the first 30 cases but later venotomy was repaired. Mean operative time was 11.3 min. No injury of the right carotid artery or vagus was reported. None had postoperative pneumothorax. Overall, 542 cases had lines until they were discharged. A total of 43 cases needed redo. Thirty-five cases had line-associated infection and 40 lines were thrombosed.Conclusion: OSC of right IJV was feasible and had lower complication rates.

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Internal jugular vein diameter in pediatric patients: are the J‐shaped guidewire diameters bigger than internal jugular vein? An evaluation with ultrasound

Cited by 36 publications

References 18 publications

Topographical anatomy of central venous system in extremely low‐birth weight neonates less than 1000 grams and the effect of central venous catheter placement

Topographical anatomy of central venous system in extremely low‐birth weight neonates less than 1000 grams and the effect of central venous catheter placement

International evidence-based recommendations on ultrasound-guided vascular access

Surgical insertion of central venous catheters in low-birth-weight neonates

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