Ultrasound-guided anatomical evaluation of right internal jugular vein in children

"The right internal jugular vein is commonly preferred for central venous cannulation, and ultrasonographic assessment and guidance is the recommended technique for this procedure" Uzumcugil and Ekinci (2020).

Abstract:

Background: The right internal jugular vein is commonly preferred for central venous cannulation, and ultrasonographic assessment and guidance is the recommended technique for this procedure. Despite the safety and reliability of this technique, it requires specific training and experience as well as thorough knowledge of anatomy.

Aim: The position of theright internal jugular vein with respect to carotid arteryand its transverse diameter free from overlap with the carotid arterywere evaluated using ultrasound in patients aged 0-2 years.

Methods: This single-centre, prospective, observationalstudy included patients aged 0-2 years who underwent elective surgery betweenJuly 2018 andJuly 2019. The diameters and anatomical position were evaluated using ultrasound. All parameters werecompared between groups classified according topostmenstrual ages. The correlations of these parameters withweight andpostmenstrual ages were analysed.

Results: A total of156 patients were included. Thediameters (p<0.001) anddepth(p=0.012) were smaller in patients with postmenstrual age<45 weeks. The anteroposterior diameter was significantly correlated withweight in patients with postmenstrual age<45 weeks, butnot in older patients. Right internal jugular vein was lateral and anterolateral with respect to carotid artery in 51.3% and 42.9% of patients, respectively, and>80% ofthe transverse diameter was free from overlap with the carotid artery.

Conclusion: Our results support the current data for the high anatomical variability of the right internal jugular vein, highlighting the recommendation of the Rapid Central Vein Assessment (RaCeVA) protocol prior to and ultrasound guidance during catheterization of central veins.

Reference:

Uzumcugil, F. and Ekinci, S. (2020) Ultrasound-guided Anatomical Evaluation of Right Internal Jugular Vein in Children Aged 0-2 Years: A Prospective Observational Study. Paediatric Anaesthesia. July 3rd. https://doi.org/10.1111/pan.13961 (epub ahead of print).

Safety IV catheter