• A-R Lee, J-H Lee, H-Y Lim, and S M Lee.
• Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju Special Self-governing Province, Korea.
• Acta Anaesthesiol Scand. 2014 May 1;58(5):580-7.

BackgroundCatheterisation of the internal jugular vein (IJV) can be difficult in infants. We aimed to evaluate whether a simple manoeuvre, a slight caudo-lateral traction of the ipsilateral arm (CLTIA), could decrease the head rotation-induced overlap of the IJV to the carotid artery (CA) in infants.MethodsTwenty-five infants were included. The patients were placed in the 10° Trendelenburg position with a shoulder roll. On both sides of the neck, ultrasound images were obtained in a transverse orientation before and after the CLTIA at 0°, 40°, and 80° of head rotation, respectively. On each image, CA overlap was calculated as follows: CA overlap (%) = (overlap distance/CA diameter) × 100.ResultsThe CLTIA decreased CA overlap (%) in 0°, 40°, and 80° of head rotation on the right side of the neck [14 (interquartile range, IQR 0-32) to 0 (IQR 0-14), 24 (IQR 0-46) to 0 (IQR 0-33), and 31 (IQR 12-58) to 23 (IQR 0-34); all P < 0.01] and on the left [29 (IQR 7-61) to 19 (IQR 0-44), 40 (IQR 21-65) to 31 (IQR 0-46), and 44 (IQR 29-97) to 33 (IQR 14-69); all P < 0.01], respectively.ConclusionThe CLTIA successfully reduced the overlap between the IJV and the CA in infants. However, further study should be needed to evaluate the clinical usefulness of the CLTIA during the IJV catheterisation.© 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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