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Central venous access via external jugular vein in children
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
Summary
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.
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