Anatomic relationship between the internal jugular vein and the carotid artery in preschool children--an ultrasonographic study.
BACKGROUND
Central venous cannulation in young children is technically difficult and may lead to potentially serious complications especially when performed blindly or using anatomical landmarks only.


OBJECTIVE
The aim of this study was to determine the anatomical relationship of the internal jugular vein (IJV) and the common carotid artery (CA) in preschool children using ultrasound.


METHODS
Forty five children aged 60 months and under were included prospectively and divided into three groups: group 1: <6 months, group 2: 7-18 months and group 3: 19-60 months. With the head in neutral position the location of the left and right IJV was noted as anterior (A), anterolateral (AL), lateral (L) or medial (M) in relation to the CA at the level of the cricoid cartilage. Depths of IJV and CA as well as time taken to locate the vessels were recorded.


RESULTS
The IJV was more commonly found in the AL position in all groups. The mean depth was 0.96 cm in group 1, 0.95 cm in group 2 and 3. Mean duration for localization of the vessels was 4.2 s in group 1, 4 s in group 2 and 4.3 s in group 3. The differences between the groups were not significant.


CONCLUSIONS
This study demonstrates that the IJV cover the CA in the majority of young children. Depth of the IJV is rarely more than 1 cm deep to the skin. Ultrasound location of the IJV and CA is easy and does not necessarily delay the procedure. The findings of this study support the use of ultrasound guidance for CVC in children.
Roth
Benjamin
B
Pôle d'Anesthésie Réanimation, Hôpital Jeanne de Flandre, CHRU Lille, France.
Marciniak
Bruno
B
Engelhardt
Thomas
T
Bissonnette
Bruno
B
D001837:Body Weights and Measures; D017536:Carotid Artery, Common / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D002405:Catheterization, Central Venous / Q000379:methods* / Q000592:standards; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007601:Jugular Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D016683:Supine Position; D018084:Ultrasonography, Interventional