DOES THE USE OF THE ULTRASOUND DEVICE DURING INTERNAL JUGULAR CANNULATION, DECREASE THE INCIDENCE OF COMPLICATIONS IN CHILDREN?

Abstract

S420 INTRODUCTION: Internal jugular (IJ) vein cannulation is technically more difficult in children than in adults. [1] We hypothesized that the use of the ultrasound device reduces the incidence of complications associated with IJ cannulation in children undergoing cardiac surgery. METHODS: Internal jugular cannulation was performed on 294 patients by anesthesia fellows or attending anesthesiologists using either traditional landmarks method (LM) or the ultrasound device (US). The choice of either method was based on the preference of the attending anesthesiologist. The following data were collected: age, success, number of attempts, cannulation time and the different complications. RESULTS: Of the 294 patients studied, 150 patients were infants and 144 patients older children. The landmark technique was used in 137 patients and the ultrasound technique was used in 157 patients. The number of attempts, cannulation time, the success rate and complications in these infants and children using either the landmark technique or the ultrasound device are shown in Table 1. The complications included, arrhythmias, guidewire kinking, difficulty in threading, arterial and venous hematomas. The significant complications of carotid artery puncture and hematoma formation were specifically evaluated in these patients.Table 1: Landmarks (LM) vs. Ultrasound (US) Technique in Two Groups of ChildrenCONCLUSIONS: There were significantly less complications during internal jugular vein cannulation when ultrasound device was used. The incidence of carotid artery puncture and hematoma formation was also significantly reduced with the use of the ultrasound device in all children. We conclude that the use of ultrasound device during IJ cannulation decreases the overall incidence of complications, especially carotid artery puncture and hematoma formation.