Sp. Etheridge et al., ECHOCARDIOGRAPHIC-GUIDED INTERNAL JUGULAR VENOUS CANNULATION IN CHILDREN WITH HEART-DISEASE, Archives of pediatrics & adolescent medicine, 149(1), 1995, pp. 77-80
Objective: To determine if cannulation of the internal jugular vein (I
JV) with echocardiographic guidance increases the success and decrease
s the complications of the procedure when performed in children with h
eart disease. Design: Twenty-five consecutive pediatric patients with
heart disease who underwent IJV cannulation with echocardiographic gui
dance between September 1986 and March 1992. Setting: University hospi
tal referral center serving a four-state area. Patients and Other Part
icipants: Ambulatory patients were admitted for this procedure and the
n discharged at its completion; others included hospitalized patients.
All patients were between the ages of 6 weeks and 21.8 years. All pat
ients underwent IJV cannulation performed by a member of the Pediatric
Cardiology Division at the University of Minnesota, Minneapolis. All
patients either underwent heart transplant, and IJV access was obtaine
d to perform an endomyocardial biopsy, or had congenital heart disease
, and the IJV was cannulated to perform a heart catheterization. Writt
en consent was obtained either from the patient, if 18 years of age or
older, or a parent or legal guardian. Intervention: Cannulation of th
e IJV using echocardiographic guidance. Main Outcome Measures: Would I
JV cannulation with echocardiographic guidance improve safety and dimi
nish complications of the procedure when performed in pediatric patien
ts with heart disease? We compared the results of our evaluation with
published results in which echocardiographic guidance was not used. Re
sults: Cannulation of the IJV with echocardiographic guidance was perf
ormed successfully on 138 occasions in 25 pediatric patients. There we
re no lasting complications and no deaths using this method of venous
access. Conclusions: As in the adult population, IJV cannulation with
the assistance of echocardiography increases the success of the proced
ure and decreases the number of complications. Furthermore, echocardio
graphic guidance allows for repeated IJV cannulation in pediatric pati
ents, regardless of age.