Internal jugular vein deformities after central venous catheterisation in neonates: evaluation by Doppler ultrasound.
OBJECTIVE
The use of a central venous catheter (CVC) through the internal jugular vein (IJV) in neonates is associated with various complications. We postulated that the risk of vein deformity after removing the CVC is underestimated. This study aimed to evaluate, using Doppler ultrasound, morphological changes in the IJV that had undergone CVC insertion during the neonatal period.


METHODS
The study consisted of 23 cases, in which 2.7 Fr Broviac (Bard Access Systems, Salt Lake City, Utah, USA) CVCs were inserted through the IJVs of newborns over a 2-year period. After the removal of the CVCs, the IJVs were examined by Doppler ultrasound.


RESULTS
Seventeen cases had normal appearances, but six (26%) cases had deformities. One case had a completely obstructed IJV, and five had abnormal compressibility, echogenic intravascular masses or monophasic waveforms of blood flow. On follow-up, IJV deformities were not improved but tended to be aggravated. There were significant differences in gestational age (36.6 +/- 3.2 weeks vs. 30.0 +/- 3.9 weeks, P= 0.002), body weight at time of CVC insertion (2.60 +/- 0.72 kg vs. 1.32 +/- 0.47 kg, P= 0.001) and duration of catheter use (25.9 +/- 13.6 days vs. 49.0 +/- 22.0 days, P= 0.016) between the normal and deformity groups, respectively.


CONCLUSIONS
IJV deformities after central venous catheterisation in neonates are common. A lower gestational age, a lower body weight, and more catheter indwelling days are significant factors affecting the incidence of IJV deformities.
Kim
Myung Joon
MJ
Department of Radiology, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Chang
Hye Kyung
HK
Lee
Mu Sook
MS
Han
Seok Joo
SJ
Oh
Jung-Tak
JT
D001835:Body Weight; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007601:Jugular Veins / Q000000981:diagnostic imaging* / Q000293:injuries*; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography