Central venous access via external jugular vein in children

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Fred W Tecklenburg1, Joel B Cochran, Sally A Webb

  • 1Division of Critical Care, Department of Pediatrics, MUSC Children's Hospital, 135 Rutledge Ave, PO Box 250566, Charleston, SC, USA. tecklenf@musc.edu

Pediatric Emergency Care
|July 27, 2010
PubMed

Insights

The external jugular (EJ) vein is a successful and safe option for central venous access in pediatric patients, with a 90% success rate and minimal complications, making it a viable alternative for critical care.

Area of Science:

  • Pediatric critical care medicine
  • Vascular access procedures
  • Interventional cardiology

Background:

  • Central venous access is crucial for critically ill children.
  • The external jugular (EJ) vein is an alternative cannulation site.
  • Assessing EJ vein efficacy and safety in pediatrics is important.

Purpose of the Study:

  • To evaluate the success rate of external jugular (EJ) vein cannulation for central venous access in pediatric patients.
  • To determine the complication rate associated with EJ vein central venous access in this population.

Main Methods:

  • A prospective cohort study was conducted in a pediatric intensive care unit.
  • 50 pediatric patients undergoing attempted central venous access via the EJ vein were enrolled.
  • Data on cannulation success, complications, and catheter dwell time were collected.

Main Results:

  • Central venous access was achieved in 90% of patients (45/50).
  • Success rates varied by age, with 50% in infants (<1 year) and 98% in older children.
  • Low complication rates were observed, including no pneumothorax or carotid artery puncture; catheter malfunction (1.21/100 catheter-days) and bloodstream infections (6.04/1000 catheter-days) occurred in a small number of patients.

Conclusions:

  • The external jugular (EJ) vein is a viable and effective site for central venous access in pediatric patients.
  • This method offers a low complication profile, supporting its use in pediatric intensive care settings.
  • Further research may explore optimizing EJ vein access in younger infants.
Abstract

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