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Echocardiographic-Guided Internal Jugular Venous Cannulation in Children With Heart Disease FREE

Susan P. Etheridge, MD; James M. Berry, RDMS; Kimberly A. Krabill, MD; Elizabeth A. Braunlin, MD, PhD
Arch Pediatr Adolesc Med. 1995;149(1):77-80. doi:10.1001/archpedi.1995.02170130079018.
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Objective:  To determine if cannulation of the internal jugular vein (IJV) with echocardiographic guidance increases the success and decreases the complications of the procedure when performed in children with heart disease.

Design:  Twenty-five consecutive pediatric patients with heart disease who underwent IJV cannulation with echocardiographic guidance between September 1986 and March 1992.

Setting:  University hospital referral center serving a fourstate area.

Patients and Other Participants:  Ambulatory patients were admitted for this procedure and then discharged at its completion; others included hospitalized patients. All patients were between the ages of 6 weeks and 21.8 years. All patients underwent IJV cannulation performed by a member of the Pediatric Cardiology Division at the University of Minnesota, Minneapolis. All patients either underwent heart transplant, and IJV access was obtained to perform an endomyocardial biopsy, or had congenital heart disease, and the IJV was cannulated to perform a heart catheterization. Written consent was obtained either from the patient, if 18 years of age or older, or a parent or legal guardian.

Intervention:  Cannulation of the IJV using echocardiographic guidance.

Main Outcome Measures:  Would IJV cannulation with echocardiographic guidance improve safety and diminish complications of the procedure when performed in pediatric patients with heart disease? We compared the results of our evaluation with published results in which echocardiographic guidance was not used.

Results:  Cannulation of the IJV with echocardiographic guidance was performed successfully on 138 occasions in 25 pediatric patients. There were no lasting complications and no deaths using this method of venous access.

Conclusions:  As in the adult population, IJV cannulation with the assistance of echocardiography increases the success of the procedure and decreases the number of complications. Furthermore, echocardiographic guidance allows for repeated IJV cannulation in pediatric patients, regardless of age.(Arch Pediatr Adolesc Med. 1995;149:77-80)

REFERENCES

Padberg FT, Ruggiero J, Blackburn GL, Bistrian BR.  Central venous catheterization for parental nutrition . Ann Surg . 1981;;193:264-270.
Scznajder JI, Zveibil FR, Bitterman H, Weiner P, Bursztein S.  Central vein catheterization: failure and complication rates by three percutanous approaches . Arch Intern Med . 1986;:146:259-261.
Latson LA, Kugler JD, Cheatham JP, Gumbiner CH, Hofschire PJ.  Percutaneous cardiac catheterization via the internal jugular vein in infants and children . Cathet Cardiovasc Diagn . 1986;;12:198-201.
Shaddy RE, Bullock EA.  Efficacy of 100 consecutive right ventricular endomyocardial biopsies in pediatric patients using the right internal jugular venous approach . Pediatr Cardiol . 1993;;14:5-8.
Garrick ML, Neches WH, Fricker FJ, Pahl E, Ettedgui JA.  Usefulness of the internal jugular venous route for cardiac catheterization in children . Am J Cardiol . 1990;;65:1276-1278.
Denys BG, Uretsky BF, Reddy PS.  Ultrasound-assisted cannulation of the internal jugular vein: a prospective comparison to the external landmark-guided technique . Circulation . 1993;;87:1557-1562.
Denys BG, Uretsky BF, Reddy PS, Ruffner RJ, Sandhu JS, Breishlatt WM.  An ultrasound method for safe and rapid central venous access . N Engl J Med . 1991;:324:566.
Yonei A, Nonoue T, Sari A.  Real-time ultrasound guidance for percutaneous puncture of the internal jugular vein . Anesthesiology . 1986;;64:830-831.
Machi J, Takeda J, Kakegawa T.  Safe jugular and subclavian venipuncture under ultrasound guidance . Am J Surg . 1987;;153:321-323.
Guccione P, Gagliardi G, Bevilacqua M, Parisi F, Marino B.  Cardiac catheterization through the internal jugular vein in pediatric patients: an alternative to the usual femoral vein access . Chest . 1992;;101:1512-1514.
Goldfarb G, Lebrec D.  Percutaneous cannulation of the internal jugular vein in patients with coagulopathies: an experience based on 1000 attempts . Anesthesiology . 1982;;56:321-323.

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References

Padberg FT, Ruggiero J, Blackburn GL, Bistrian BR.  Central venous catheterization for parental nutrition . Ann Surg . 1981;;193:264-270.
Scznajder JI, Zveibil FR, Bitterman H, Weiner P, Bursztein S.  Central vein catheterization: failure and complication rates by three percutanous approaches . Arch Intern Med . 1986;:146:259-261.
Latson LA, Kugler JD, Cheatham JP, Gumbiner CH, Hofschire PJ.  Percutaneous cardiac catheterization via the internal jugular vein in infants and children . Cathet Cardiovasc Diagn . 1986;;12:198-201.
Shaddy RE, Bullock EA.  Efficacy of 100 consecutive right ventricular endomyocardial biopsies in pediatric patients using the right internal jugular venous approach . Pediatr Cardiol . 1993;;14:5-8.
Garrick ML, Neches WH, Fricker FJ, Pahl E, Ettedgui JA.  Usefulness of the internal jugular venous route for cardiac catheterization in children . Am J Cardiol . 1990;;65:1276-1278.
Denys BG, Uretsky BF, Reddy PS.  Ultrasound-assisted cannulation of the internal jugular vein: a prospective comparison to the external landmark-guided technique . Circulation . 1993;;87:1557-1562.
Denys BG, Uretsky BF, Reddy PS, Ruffner RJ, Sandhu JS, Breishlatt WM.  An ultrasound method for safe and rapid central venous access . N Engl J Med . 1991;:324:566.
Yonei A, Nonoue T, Sari A.  Real-time ultrasound guidance for percutaneous puncture of the internal jugular vein . Anesthesiology . 1986;;64:830-831.
Machi J, Takeda J, Kakegawa T.  Safe jugular and subclavian venipuncture under ultrasound guidance . Am J Surg . 1987;;153:321-323.
Guccione P, Gagliardi G, Bevilacqua M, Parisi F, Marino B.  Cardiac catheterization through the internal jugular vein in pediatric patients: an alternative to the usual femoral vein access . Chest . 1992;;101:1512-1514.
Goldfarb G, Lebrec D.  Percutaneous cannulation of the internal jugular vein in patients with coagulopathies: an experience based on 1000 attempts . Anesthesiology . 1982;;56:321-323.

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