J M López Álvarez1, O Pérez Quevedo2, L Santana Cabrera3, C Rodríguez Escot3, T Ramírez Lorenzo4, J M Limiñana Cañal4, J F Loro Ferrer5. 1. Unit of Intensive Pediatric Medicine, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of Canarias), Las Palmas, Gran Canaria, Spain. jmloal@hotmail.com. 2. Unit of Intensive Pediatric Medicine, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of Canarias), Las Palmas, Gran Canaria, Spain. 3. Service of Intensive Medicine, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of Canarias), Las Palmas, Gran Canaria, Spain. 4. Unit for Support of Research, Department of Biostatistics, University of Las Palmas de GC, Las Palmas, Gran Canaria, Spain. 5. Department of Clinical Sciences, University of Las Palmas de GC, Las Palmas, Gran Canaria, Spain.
Abstract
OBJECTIVE: To measure the depth (D p) and diameter (D m) of the internal jugular vein (IJV), femoral vein (FV), and femoral artery (FA) in pediatric patients to evaluate the clinical implications. METHODS: This study included 125 pediatric patients. All of them underwent bilateral ultrasound study of vessels and were classified into three groups based on anthropometric and demographic parameters. RESULTS: Measured mean D p values were: 0.72 (0.34) cm for the FA, 0.79 (0.35) cm for the FV, and 0.77 (0.24) cm for the IJV. Mean antero-posterior D m values were: 0.37 (0.17) cm for the FA, 0.42 (0.22) cm for the FV, and 0.59 (0.23) cm for the IJV. D p and D m increased with age (A), weight (W), height (H), and body surface area (BSA). In the lower ranges of these variables, D p was similar for all three studied vessels (0.6-0.7 cm). In the higher ranges, femoral vessel D p values (1.1-1.2 cm) were larger than jugular ones (0.9 cm). Additionally, in these low ranges, IJV D m values were larger than femoral ones (0.45-0.50 vs. 0.25 cm). In the higher ranges, diameter values were similar (0.6-0.7 cm). CONCLUSIONS: In pediatric patients, major vessels can be located and their depth and diameter measured by vascular ultrasound. In younger patients, jugular and femoral vessels had similar depth values; in older ones, they had similar diameters. Ultrasound measurements in pediatric patients could facilitate the choice of the vessel to be cannulated, the catheter diameter, and the length of the needle to be used. Vascular canalization of IJV may be recommended as the first choice because of its low depth and large diameter.
OBJECTIVE: To measure the depth (D p) and diameter (D m) of the internal jugular vein (IJV), femoral vein (FV), and femoral artery (FA) in pediatric patients to evaluate the clinical implications. METHODS: This study included 125 pediatric patients. All of them underwent bilateral ultrasound study of vessels and were classified into three groups based on anthropometric and demographic parameters. RESULTS: Measured mean D p values were: 0.72 (0.34) cm for the FA, 0.79 (0.35) cm for the FV, and 0.77 (0.24) cm for the IJV. Mean antero-posterior D m values were: 0.37 (0.17) cm for the FA, 0.42 (0.22) cm for the FV, and 0.59 (0.23) cm for the IJV. D p and D m increased with age (A), weight (W), height (H), and body surface area (BSA). In the lower ranges of these variables, D p was similar for all three studied vessels (0.6-0.7 cm). In the higher ranges, femoral vessel D p values (1.1-1.2 cm) were larger than jugular ones (0.9 cm). Additionally, in these low ranges, IJV D m values were larger than femoral ones (0.45-0.50 vs. 0.25 cm). In the higher ranges, diameter values were similar (0.6-0.7 cm). CONCLUSIONS: In pediatric patients, major vessels can be located and their depth and diameter measured by vascular ultrasound. In younger patients, jugular and femoral vessels had similar depth values; in older ones, they had similar diameters. Ultrasound measurements in pediatric patients could facilitate the choice of the vessel to be cannulated, the catheter diameter, and the length of the needle to be used. Vascular canalization of IJV may be recommended as the first choice because of its low depth and large diameter.
Authors: Lewis A Eisen; Mangala Narasimhan; Jeffrey S Berger; Paul H Mayo; Mark J Rosen; Roslyn F Schneider Journal: J Intensive Care Med Date: 2006 Jan-Feb Impact factor: 3.510