External jugular venous access in children: A low cost and feasible route for emergency fluid resuscitation and inotropic therapy in resource poor clinical settings?

Abstract

Introduction: The External Jugular Vein is superficial with a wide caliber and is also isolated from major neurovascular structures in neck. It can be simply cannulatedand used for fluid and inotrope administration without any major complications. Objectives: The goal of our retrospective pilot study is to demonstrate the feasibility of External Jugular Vein (EJV) access in the pediatric population in emergency settings. Methods: A total of seventy five childrenwere retrospectively evaluated after EJV cannulation. Results: EJV cannulation was successful in 63 children (84%) at the first attempt while 12 children (16%) required more than one attempt. All patients received vasoactive agents through the EJVcannula. Nineteen (25.33%) children had EJV cannulation related complications. Conclusions: As per our observations in this pilot study, vasoactive agents and intravenous fluids for resuscitation can be safely infused through the EJV in majority of children without any major complications. This route of administration could be considered especially in emergency and resource poor settings.