Masui. The Japanese journal of anesthesiology
-
Relationships between common carotid arteries (CCA) and internal jugular veins (IJV) have been investigated both in adults and children. Overlapping of CCA and IJV are reported in 70 to 90% of cases; however we seldom observe overlapping cases in children. We evaluate the relationships between CCA and IJV in children. ⋯ There appears to be little danger of puncturing the CCA during internal jugular venipuncture from the viewpoint of anatomical relationships between the CCA and IJV
-
A baby girl, 15-month-old, 75.6 cm in height, and 7.5 kg in weight, was scheduled to undergo ventricular septal defect repair. The right IJV, 3.0 mm in thickness and 7.0 mm in depth, was punctured to place a central venous catheter with a 19-mm-long 24G puncture needle. Non-pulsatile bright red blood appeared during the 15.8-mm-long needle insertion and dark red blood appeared during the 14.7-mm-long needle insertion. ⋯ The 14.7-mm-long needle inserted at a 45-degree angle reached about 10.4 mm, which is near the posterior wall of the IJV It seemed that a small artery behind the IJV was punctured mistakenly. In withdrawing blood from a cyanotic patient, it may be difficult to judge if the blood was arterial because it was non-pulsatile when it appeared. We should be careful to know the existence of small arteries behind IJVs and to confirm which vessels the returned blood comes from.