Abstract:
Background Children have the characteristics of heavy head, short neck, and unobvious sternocleidomastoid muscles. Thus, internal jugular vein puncture using anatomical landmarks technique is difficult to perform and carries a high incidence of failure in pediatric population. Ultrasound imaging technology can reveal the target blood vessel image non-invasively, providing a reference for pediatric internal jugular vein puncture.
Objective To investigate the anatomical relationship between the right internal jugular vein (IJV) and the common carotid artery (CCA) at different levels using ultrasound.
Methods From April to July in 2020, a total of 125 children scheduled for surgery aged from 4 months to 11 years in Guangzhou Women and Children’s Medical Center and Hainan Hospital of Chinese PLA General Hospital, including 82 males and 43 females, were included and divided into infant group (GA), toddler group (GB), preschool group (GC) and school-age group (GD). The transverse diameter, anteroposterior diameter, cross-sectional area of the IJV and the CCA, as well as the overlap rate and the angle between the two of each patient were scanned and measured at the right upper border of the thyroid cartilage level (TC), cricoid cartilage level (CC) and second tracheal ring level (ST) to record the relationship and variation between IJV and CCA.
Results Both in the GB and GC groups, the overlap distance and the overlap rate were ST>CC>TC, and the pairwise comparisons were statistically significant (all P<0.05), while no statistical difference of the overlap and IJV variation was obtained in the GA and GD groups (P>0.05). No difference of the position relationship between IJV and CAA was seen at three anatomical levels in all four groups (P>0.05).
Conclusion Ultrasound imaging technology indicates that the overlap rate and overlap distance of arteries and veins at the TC are the lowest in children aged 1 to 6 years, and this place can be the first choice in clinical practice as the IJV puncture point.
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