• Benjamin Roth, Bruno Marciniak, Thomas Engelhardt, and Bruno Bissonnette.
• Pôle d'Anesthésie Réanimation, Hôpital Jeanne de Flandre, CHRU Lille, France.
• Paediatr Anaesth. 2008 Aug 1;18(8):752-6.

BackgroundCentral venous cannulation in young children is technically difficult and may lead to potentially serious complications especially when performed blindly or using anatomical landmarks only.AimThe aim of this study was to determine the anatomical relationship of the internal jugular vein (IJV) and the common carotid artery (CA) in preschool children using ultrasound.MethodsForty five children aged 60 months and under were included prospectively and divided into three groups: group 1: <6 months, group 2: 7-18 months and group 3: 19-60 months. With the head in neutral position the location of the left and right IJV was noted as anterior (A), anterolateral (AL), lateral (L) or medial (M) in relation to the CA at the level of the cricoid cartilage. Depths of IJV and CA as well as time taken to locate the vessels were recorded.ResultsThe IJV was more commonly found in the AL position in all groups. The mean depth was 0.96 cm in group 1, 0.95 cm in group 2 and 3. Mean duration for localization of the vessels was 4.2 s in group 1, 4 s in group 2 and 4.3 s in group 3. The differences between the groups were not significant.ConclusionThis study demonstrates that the IJV cover the CA in the majority of young children. Depth of the IJV is rarely more than 1 cm deep to the skin. Ultrasound location of the IJV and CA is easy and does not necessarily delay the procedure. The findings of this study support the use of ultrasound guidance for CVC in children.

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