[A reliable method for internal jugular vein catheterization for neonates and infants using a small-caliber Doppler...

Eighteen neonates and infants scheduled for cardiac surgery, ranging from 1 to 42 months in ages and from 1.9 to 14.6 kg in weight, were placed in supine position under general anesthesia. The neck was moderately extended with the head turned to the left. The pathways of the right carotid artery and the internal jugular vein (IJV) were located with a Doppler probe (2.0 mm in diameter, HAYASHI Electric, TOKYO) using 10 MHz ultrasound wave. The pathways of the vessels were drawn on the skin surface and the IJV was cannulated with a 24-gauge catheter over needle (Neophron, Ohmeda, USA) along the drawn pathway. A 0.015-inch guidewire was passed through the 24-guage catheter, and a central venous catheter was placed in the IJV employing to the Seldinger method. In 16 out of 18 patients the pathways of the IJV was clearly differentiated from that of the carotid artery and the catheterization was successful without any undesirable events. In the remaining 2 patients the left IJV was catherized using the same method. No complications related to the catheterization were observed. Our catheterization method is thought to be highly reliable and safe in small pediatric patients.