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Venous patency after open central-venous cannulation.

I E Willetts¹, M Ayodeji, W H Ramsden

¹Department of Paediatric Surgery, United Leeds Teaching Hospitals NHS Trust, UK.

Pediatric Surgery International

|August 24, 2000

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Doppler ultrasound scans can assess internal jugular vein (IJV) patency after central venous catheter (CVC) placement in children. While valuable, USS findings require cautious interpretation, as collateral veins can mimic patency, impacting successful recannulation rates.

Area of Science:

Pediatric Surgery
Vascular Imaging
Interventional Radiology

Background:

Central venous cannulation (CVC) is common in pediatric care.
Re-cannulation of internal jugular veins (IJVs) is often necessary.
Assessing IJV patency prior to re-cannulation is crucial.

Purpose of the Study:

To evaluate the diagnostic accuracy of Doppler ultrasound (USS) for assessing IJV patency.
To determine the reliability of USS in children needing repeat CVC.
To assess the success rate of re-cannulating previously accessed IJVs.

Main Methods:

Prospective study of 66 children undergoing repeat CVC.
Doppler USS performed prior to surgical exploration.
Surgical exploration to confirm USS findings of IJV patency.

Related Experiment Videos

Analysis of USS findings (patent, stenosed, obliterated) versus surgical outcomes.

Main Results:

Doppler USS indicated patency in 88.6% of IJVs.
Surgical exploration confirmed patency in 89.4% of "USS patent" veins.
Seven cases (10.6%) of "USS patent" veins were found obliterated during surgery, often due to collateral vessels.
Overall successful recannulation rate was 74.6% for previously accessed IJVs.

Conclusions:

Doppler USS is a valuable, though not perfectly reliable, tool for assessing IJV patency in children requiring repeat CVC.
USS findings should be interpreted cautiously, considering the potential for collateral vessel formation.
Approximately three-fourths of previously cannulated IJVs remain patent and suitable for re-cannulation.