Abstract 266

INTRODUCTION: Internal jugular vein (IJV) cannulation in children is a routine monitor in children undergoing cardiac surgery. The success rate and frequency of complications associated with IJV cannulation were prospectively studied in 1112 infants and children in over a period of 12 years.

METHODS: All procedures were performed by pediatric anesthesia fellows (CA-3 or higher) or attending anesthesiologists. The following data were prospectively collected in children undergoing cardiac surgery who required IJV cannulation: age, weight, success rate, number of attempts, cannulation time and type of complications.

RESULTS: 1112 patients (1 day to 20 years of age with a median age of 18 months) were studied. 1008 patients were less than 10 years of age (91%). The number of attempts, cannulation time, success rate and complications in the different age groups are shown in Table 1. The overall success rate was 87.2%. The complications included cardiac arrhythmias, guide wire kinking, arterial and venous hematoma formation. However, the potentially most serious complications were carotid artery (C.A.) punctures with or without hematoma formation (13.3%).

Table 1 No caption available
Full size table

CONCLUSION: The success rate of IJV cannulation is significantly lower in infants as compared to children over 1 year of age. There is also a significant increase in the number of cannulation attempts, cannulation time and overall complications in infants as compared to older children. However, the risk of carotid artery puncture and hematoma formation during IJV cannulation does not seem to correlate with the age of the child. We conclude that IJV cannulation performed in a pediatric institution, although technically more difficult in infants, is not associated with a higher carotid artery puncture rate than in children over 12 months of age.