Central Venous Access Via External Jugular Vein in Children

Objective: To determine the success rate and complications of using the external jugular (EJ) vein for central venous access in pediatric patients. Methods: Prospective cohort study of children who underwent attempts at EJ vein central venous access while receiving care in an 11-bed pediatric intensive care unit at an urban children's hospital. Results: Over a period of 15 months, 50 patients had EJ venous cannulation attempts. Central venous access was achieved in 45 patients (90%). Successful central venous access was performed in 4 children (50%) younger than 1 year and in 36 older children (98%). Catheter-tip malposition on chest radiograph required subsequent line manipulation in 2 patients. No complications of pneumothorax or carotid artery puncture occurred during line insertion. The catheters were used for an average of 7.5 days (range, 1-28 days). Catheter malfunction occurred in 4 (1.21/100 catheter-days), and catheter-related bloodstream infections occurred in 2 patients (6.04/1000 catheter-days). No thrombotic complications were clinically detected. Conclusions: The EJ vein is a viable site for central venous access with a low complication rate in pediatric patients.