title: Differences in anatomical relationship between vertebral artery and internal jugular vein in children and adults measured by ultrasonography.
abstract: Cannulation of the internal jugular vein (IJV) under ultrasound guidance can reduce complications, such as common carotid artery (CCA) puncture, accidental vertebral artery (VA) puncture. However, these complications still occur, especially in pediatric patients probably due to anatomical predisposition of VA. This study compared differences in anatomical location of VA and IJV between pediatric and adult patients. Children with body weight <20 kg (n = 16) and adults who required central venous or pulmonary arterial pressure monitoring (n = 21) were enrolled. After induction of general anesthesia and tracheal intubation, patients were positioned for IJV cannulation. Images of the right CCA, IJV and VA were recorded by ultrasonography. The size of each vessel, anatomical relationship of other vessels, distance between vessels and between each vessel and skin were measured. The size of VA relative to IJV was significantly larger in children than in adults (14 vs 7 %, P < 0.001). The absolute and relative distance between IJV and VA were significantly shorter in children than those in adults (P < 0.01). The anatomical relationships between IJV and CCA and that between IJV and VA were not different between children and adults. In children, VA was relatively larger and located closer to IJV than adults. The results call for careful attention to the position of VA during ultrasound-guided IJV cannulation especially in children.
authors.affiliation: Department of Anesthesia and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, 812-8582, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: Operating Rooms, Kyushu University Hospital, Fukuoka, Fukuoka, 812-8582, Japan. keny@fukuoka-u.ac.jp.|Department of Anesthesiology, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 814-0180, Japan. keny@fukuoka-u.ac.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Yamaura
authors.affiliation: Department of Anesthesia and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, 812-8582, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Karashima
authors.affiliation: Operating Rooms, Kyushu University Hospital, Fukuoka, Fukuoka, 812-8582, Japan.
authors.forename: Kozaburo
authors.initials: K
authors.lastname: Akiyoshi
authors.affiliation: Department of Anesthesia and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, 812-8582, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Hoka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007223:Infant; D007601:Jugular Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods*; D014711:Vertebral Artery / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult
keywords: Children; Complications; Internal jugular vein; Ultrasound-guided central venous cannulation; Vertebral artery