Central venous access via external jugular vein in children.
OBJECTIVE
To determine the success rate and complications of using the external jugular (EJ) vein for central venous access in pediatric patients.


METHODS
Prospective cohort study of children who underwent attempts at EJ vein central venous access while receiving care in an 11-bed pediatric intensive care unit at an urban children's hospital.


RESULTS
Over a period of 15 months, 50 patients had EJ venous cannulation attempts. Central venous access was achieved in 45 patients (90%). Successful central venous access was performed in 4 children (50%) younger than 1 year and in 36 older children (98%). Catheter-tip malposition on chest radiograph required subsequent line manipulation in 2 patients. No complications of pneumothorax or carotid artery puncture occurred during line insertion. The catheters were used for an average of 7.5 days (range, 1-28 days). Catheter malfunction occurred in 4 (1.21/100 catheter-days), and catheter-related bloodstream infections occurred in 2 patients (6.04/1000 catheter-days). No thrombotic complications were clinically detected.


CONCLUSIONS
The EJ vein is a viable site for central venous access with a low complication rate in pediatric patients.
Tecklenburg
Fred W
FW
Division of Critical Care, Department of Pediatrics, MUSC Children's Hospital, 135 Rutledge Ave, PO Box 250566, Charleston, SC, USA. tecklenf@musc.edu
Cochran
Joel B
JB
Webb
Sally A
SA
Habib
David M
DM
Losek
Joseph D
JD
D000293:Adolescent; D002405:Catheterization, Central Venous / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy*; D005500:Follow-Up Studies; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007601:Jugular Veins; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult