Internal Jugular Vein Catheterization in Infants Undergoing Cardiovascular Surgery

Hayashi, Yukio; Uchida, Osamu; Takaki, Osamu; Ohnishi, Yoshihiko; Nakajima, Toshito; Kataoka, Hiroto; Kuro, Masakazu

doi:10.1213/00000539-199205000-00012

Cited by 88 publications

(57 citation statements)

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“…Mortensen et al (17) reported correlations between body weight and surface area with vein diameter, with a stronger correlation for femoral veins compared to internal jugular veins. Hayashi et al (18) conducted a cohort study assessing the use of US-guided CVC insertion in 106 children <20 kg and reported significantly lower success rates in infants <3 mo (81.3 vs. 100.0%, P < 0.05) and infants <4 kg (78.6 vs. 100.0%, P < 0.05) compared to children >3 mo and >4 kg.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis

Lau

Chamberlain

2016

Pediatr Res

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Background: Real-time ultrasound (US) guidance for central venous catheter (CVC) insertion has been shown to increase cannulation success rates and reduce complications in adults. Literature regarding US-guided CVC placement in children remains limited and conflicting. This meta-analysis examines the efficacy and safety of US-guided CVC placement among pediatric patients. Methods: A comprehensive literature search of all published randomized control trials (RCTs) comparing the use of real-time US-guided CVC insertion with anatomic landmark (LM)-guided CVC insertion in pediatric patients <18 y of age was conducted. Outcomes analyzed were cannulation success rate, number of attempts required, incidence of accidental arterial puncture, and time to cannulation. results: Eight RCTs involving 760 patients were analyzed. US-guided CVC insertion significantly increased success rates by 31.8% and decreased the mean number of attempts required. A trend toward a decrease in the risk of accidental arterial puncture with the use of US-guided CVC insertion was also observed. US-guided CVC insertion was not associated with a significant difference in time required for CVC placement. conclusion: US-guided CVC placement is associated with significantly higher success rates and decreased mean number of attempts required for cannulation. US-guided CVC insertion improves success rates, and should be utilized in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis

Lau

Chamberlain

2016

Pediatr Res

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“…Hayashi et al (26) reported a success rate of 97.2% for percutaneous cannulations in 106 children; however, this success rate decreased to 81.3% when the patient was aged below three months.…”

Section: Discussionmentioning

confidence: 99%

The effects of the Trendelenburg position and the Valsalva manoeuvre on internal jugular vein diameter and placement in children

Dinçyürek

Moğol

Türker

et al. 2015

smedj

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INTRODUCTIONWe compared the effects of various surgical positions, with and without the Valsalva manoeuvre, on the diameter of the right internal jugular vein (RIJV). METHODSWe recruited 100 American Society of Anesthesiologists physical status class I patients aged 2-12 years. The patients' heart rate, blood pressure, peripheral oxygen saturation and end-tidal CO 2 pressure were monitored. Induction of anaesthesia was done using 1% propofol 10 mg/mL and fentanyl 2 μg/kg, while maintenance was achieved with 2% sevoflurane in a mixture of 50/50 oxygen and air (administered via a laryngeal mask airway). The RIJV diameter was measured using ultrasonography when the patient was in the supine position. Thereafter, it was measured when the patient was in the supine position + Valsalva, followed by the Trendelenburg, Trendelenburg + Valsalva, reverse Trendelenburg, and reverse Trendelenburg + Valsalva positions. A 15° depression or elevation was applied for the Trendelenburg position, and an airway pressure of 20 cmH 2 O was applied in the Valsalva manoeuvre. During ultrasonography, the patient's head was tilted 20° to the left. CONCLUSION In paediatric patients, the application of the Trendelenburg position with the Valsalva manoeuvre gave the greatest increase in RIJV diameter. The reverse Trendelenburg position had no significant effect on RIJV diameter. RESULTS

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“…65 A recent report examined the factors influencing successful cannulation of the internal jugular vein in infants using the high approach favoured by most institutions. 55 The overall success rate was 97.2% but this decreased to 78.6% with children < 4 kg.…”

Section: Internal Jugular Veinmentioning

confidence: 92%

Monitoring during paediatric cardiac anaesthesia

Purday

1994

Can J Anaesth

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Monitoring of paediatric anaesthesia has become increasingly more complex in recent years (precordial, oesophageal or paratracheal). Specialized monitoring includes the monitoring of mixed venous oxygenation saturation (S~O2) which is being increasingly used within the critical care area. Transoesophageal echocardiography (TOE) has become accepted in adult cardiac surgery particularly in the fields of mitral valve repair and aortic root surgery, where it allows immediate assessment of the adequacy of repair. The place of TOE in congenital heart disease is now becoming more clearly defined. Cerebral function monitoring is an area of a great deal of research and several new monitoring methods are under review. The use of the thromboelastogram in monitoring coagulation has been found to decrease blood and fluid replacement during liver transplantation and its use during cardiac surgery is increasing. Other end organs that are affected by cardiopulmonary bypass (CPB) include the gut; liver and immune system, possibly leading to multi-organ failure in some cases, and interest is being shown in their monitoring.The purpose of this review is to present the recent publications relating to specific areas of both standard and specialized monitoring and indicate areas where these monitors may prove particularly useful to the practitioner involved in the care of paediatric cardiac patients. Routine monitoring ElectrocardiogramThe ECG displays the electrical activity of the heart. Abnormalities in the ECG can reflect alterations in rate or rhythm and changes in the ST segment may incidate underlying ischaemia. The normal ECG in childhood changes with age and shows several differences from the adult, particularly in the first few years of life where the right ventrical mass is dominant. There are several general changes that occur with increasing age (Table I). Heart rate (HR), frontal plane QRS vector (axis), PR interval, R wave heights and T waves are some of the factors that alter with age (Table II) and the reader is referred to a more specialized review for further information. 1,2 In adult cardiac surgery there has been investigation of perioperative myocardial ischaemia, its prognosis, and the best way of detecting it. 3,4 In children, however, there has been little work looking at the ST segment. Bell et al. ~ reported three cases of ST changes in neonates consistent with myocardial ischaemia. The first case involved a child of 26 wk who developed ST changes during awake laryngoscopy and lung retraction that were presumed to be related to myocardial hypoxia, although pulse oximetry readings were not mentioned. In the second case, ST changes improved on starting trinitroglycerine, isoproterenol and dopamine and in the third were related to ectiocardiographic changes. Cherian and Rao 6 associate the ST segment with the adequacy of coronary blood flow during the arterial switch operation for transposition. Observing leads I and V 5 for the left coronary and lead II for the right, greater than 1 mm elevation for more tha...

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Internal Jugular Vein Catheterization in Infants Undergoing Cardiovascular Surgery

Cited by 88 publications

References 0 publications

Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis

Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis

The effects of the Trendelenburg position and the Valsalva manoeuvre on internal jugular vein diameter and placement in children

Monitoring during paediatric cardiac anaesthesia

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