The airway device preference may affect the overlapping of the common carotid artery by the internal jugular vein

Abstract

Laryngeal mask airway with 40° head rotation increases, whereas ETT decreases, the overlap percentage of CCA by IJV. Both head position and airway management methods have an influence on the overlap of the CCA by the IJV in pediatric patients.

Ultrasound‐guided anatomical evaluation of right internal jugular vein in children aged 0‐2 years: A prospective observational study

“…Yuan et al 1 applied similar head‐neck positions as ours, but used a laryngeal mask airway (LMA), which was different from our study. The use of an laryngeal mask airway was previously reported to increase the overlap percentage with the 40° head‐neck position, which may be the cause of this difference 11 . In our previous study, in which we reported the diameter and position of the RIJV in 25 infants weighing <4000 g, the incidences of positions differed from our results in this study 12 .…”

“…In some previously reported studies addressing the degree of overlap of the RIJV and CA, the overlap percentage of the RIJV and CA was calculated using different techniques. In the studies by Özçelik et al 11 and Gwak et al, 13 the percentage of transverse diameter of the CA overlapped by the RIJV was calculated in terms of the percentage of the transverse diameter of the CA. However, in our study, we calculated the percentage of the transverse diameter of the RIJV that was free from overlap with the CA, because we thought that it would be reasonable to determine the area that the needle was advanced in order to avoid arterial puncture.…”

Ultrasonographic Assessment of Anatomic Relationship Between the Internal Jugular Vein and the Common Carotid Artery in Infants and Children After ETT or LMA Insertion: A Prospective Observational Study

“…An et al (15) demonstrated that the application of positive end-expiratory pressure at 10 and 15 cm H2O increases the size of the right IJV in patients receiving mechanical ventilation with LMA insertion, but the overlap index of the IJV and the CCA increased as well, so this strategy was not adopted. There are conflicting results regarding the optimal angle of the head rotated to the contralateral side after airway devices insertion in children and adults (1,7,9,10,12). We adopted the 30 • head rotated position because the overlap percentage of the IJV and the CCA likely increases at rotation angles in excess of 30 • .…”

“…Ozcelik et al (10) studied the overlap percentage of the CCA by the IJV after airway device insertion in a neutral head position and 40 • head rotation position in 92 subjects aged 0-17 years. In contrast to our study, they demonstrated that LMA with the 40 • head rotation increased the overlap percentage of the CCA by the IJV and ETT decreased the overlap percentage.…”

“…It has been reported that the anatomic relationship between the IJV and the CCA changed significantly and the degree of overlap between the IJV and the CCA also increased in adults after LMA placement (7). However, there are conflicting results regarding the anatomic relationship between the IJV and the CCA after ETT or LMA insertion in pediatric populations (8)(9)(10). Therefore, we believe that it is important for us to investigate this topic.…”