The Importance of Ultrasound-guided Central Venous Cannulation in Children: Evaluation of the Relationship Between the Internal Jugular Vein and the Carotid Artery

Introduction: Central venous cannulation is widely used in critically ill patients.Although the landmark-guided technique has a high success rate, it can cause serious complications due to anatomical variations.The aim of this study was to determine the anatomical variations between the internal jugular vein (IJV) and carotid artery (CA).Another aim of the study is to reveal the risk of complications associated with cannulation performed using anatomical landmark guidance.Methods: This retrospective study included 61 patients admitted to the pediatric intensive care unit.Information was obtained from the recorded files.Descriptive statistical analyses, the chi-square, Fisher's exact, and Bonferroni tests, and multivariate logistic regression analysis were used as statistical tools.Results: Thirty-six patients were male and 25 were female.The most common admission diagnosis was respiratory failure (60.1%).The mean age of the patients was 58.1±62 months (2 to 192 months).Most catheterizations were performed unilaterally.The right side was predominantly preferred.The most common locations of the IJV and CA on both sides were anterolateral.Significant overlap was detected on the right side in 18 patients (29.5%) and on the left side in 21 patients (34.4%).It was also observed that, on the left side, as weight and age decreased, the overlap increased significantly. Conclusion:Our findings support the routine use of ultrasound (USG)-guided catheterization in children.This study has shown that the risk of complications is high in catheterization procedures performed without USG, especially in infants and underweight children.