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Ultrasound evaluations of internal jugular vein punction techniques in children: the easiest method to reach the target area

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Abstract

The objective of this study is to determine the best way to access and the position in which the patients must remain in order to obtain the best transversal section of the right internal jugular vein (RIJV) section during the catheterization by ultrasound, allowing a safer and precise access. The three possible ways to access the RIJV, anterior, lateral and posterior, from 57 healthy children, were examined by ultrasound in one similar sequence of positions: horizontal dorsal decubitus with the head centered in neutral position with and without the use of a pillow; horizontal dorsal decubitus with contralateral rotation of the head with and without the use of a pillow; horizontal dorsal decubitus with the head centered in neutral position and the patient in the Trendelenburg position without the use of a pillow. The relation between the different positions and punction regions in RIJV were established using analysis of variance. As a result, the lateral punction with the patient in the Trendelemburg position offered a largest area of the RIJV transversal section in comparison to all the other options (P < 0.0001). In conclusion, this study demonstrated that the safer and precise way for the RIJV catheterization in pediatric patients is obtained in Trendelenburg position with lateral access and without a pillow.

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Authors and Affiliations

  1. Pediatric Surgery Division, Surgery Department, Federal University of Sao Paulo, São Paulo, Brazil

    Luiz Fernando Ybarra, H. Ruiz, M. P. Silva, H. M. Lederman & S. T. Schettini

  2. Department of Diagnostic Imaging, Federal University of Sao Paulo, São Paulo, Brazil

    Luiz Fernando Ybarra, H. Ruiz, M. P. Silva, H. M. Lederman & S. T. Schettini

  3. Rua Capote Valente, 671, apt 40, São Paulo, SP, 05409-002, Brazil

    Luiz Fernando Ybarra

Authors
  1. Luiz Fernando Ybarra
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  2. H. Ruiz
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  3. M. P. Silva
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  4. H. M. Lederman
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  5. S. T. Schettini
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Correspondence to Luiz Fernando Ybarra.

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The experiments comply with the current laws of the Brazilian legislation, country in which they were performed.

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Ybarra, L.F., Ruiz, H., Silva, M.P. et al. Ultrasound evaluations of internal jugular vein punction techniques in children: the easiest method to reach the target area. Pediatr Surg Int 25, 99–104 (2009). https://doi.org/10.1007/s00383-008-2298-2

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  • DOI: https://doi.org/10.1007/s00383-008-2298-2

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