Ultrasound-guided internal jugular vein cannulation versus blind technique in pediatric cancer patients

ABSTRACT

Percutaneous Cannulation of the internal jugular vein in infants and children is technically more difficult and carries a higher risk of complication than in adults. The authors tested their hypothesis that using an ultrasound scanner would increase the success of internal jugular Cannulation and decrease the incidence of complication in pediatric cancer patients. After approval from the hospital ethical committee [75375 hospital] and receipt of written informed parental consent, 108 children scheduled for internal jugular vein Cannulation were randomized into two groups; landmark group using the traditional method and ultrasound group, using sonography guidance for insertion. The access time, number of attempts, success rate, and incidence of complications were compared for the two groups. There were no significant differences between the two groups with regard to age, sex, weight and coagulation profile. The success rate was 98.1% in the ultrasound group, with one case of carotid artery puncture, versus 85.2% in the landmark group, with a 14.8% incidence of carotid artery puncture. Both differences were significant [p<0.001]. The access time was less, the number of attempts was fewer significantly in the ultrasound group than in the landmark group. No cases of hemothorax or pneumothorax occurred in this group. Ultrasonographic localization of the internal jugular vein was superior to the landmark technique in terms of overall success, speed and decreased incidence of complication