Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Medical Ultrasonics
Published in: Journal of Medical Ultrasonics 3/2018

01-07-2018 | Original Article

Vascular ultrasound in pediatrics: utility and application of location and measurement of jugular and femoral vessels

Authors: J. M. López Álvarez, O. Pérez Quevedo, L. Santana Cabrera, C. Rodríguez Escot, T. Ramírez Lorenzo, J. M. Limiñana Cañal, J. F. Loro Ferrer

Published in: Journal of Medical Ultrasonics | Issue 3/2018

Login to get access

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.
Literature
1.
Aubaniac R. Subclavian intravenous injection; advantages and technic. Presse Med. 1952;60:1456.PubMed
2.
Seldinger SI. Catheter replacement of the needle in percutaneous arteriography: a new technique. Acta Radiol. 1953;39:368–76.CrossRefPubMed
3.
Hermosura B, Vanags L, Dickey MW. Measurement of pressure during intravenous therapy. JAMA (J Am Med Assoc). 1966;195:321.CrossRef
4.
Farinas PL. Retrograde abdominal aortography: a contribution to the study of the abdominal aorta and iliac arteries. Radiology. 1946;47:344–8.CrossRefPubMed
5.
Alderson PJ, Burrows FA, Stemp LI, et al. Use of ultrasound to evaluate internal jugular vein anatomy and to facilitate central venous cannulation in paediatric patients. Br J Anaesth. 1993;70:145–8.CrossRefPubMed
6.
Warkentine FH, Clyde Pierce M, Lorenz D, et al. The anatomic relationship of femoral vein to femoral artery in euvolemic pediatric patients by ultrasonography: implications for pediatric femoral central venous access. Acad Emerg Med Off J Soc Acad Emerg Med. 2008;15:426–30.CrossRef
7.
Hopkins JW, Warkentine F, Gracely E, et al. The anatomic relationship between the common femoral artery and common femoral vein in frog leg position versus straight leg position in pediatric patients. Acad Emerg Med Off J Soc Acad Emerg Med. 2009;16:579–84.CrossRef
8.
Chiang VW, Baskin MN. Uses and complications of central venous catheters inserted in a pediatric emergency department. Pediatr Emerg Care. 2000;16:230–2.CrossRefPubMed
9.
Maecken T, Grau T. Ultrasound imaging in vascular access. Crit Care Med. 2007;35:178–85.CrossRef
10.
11.
Eisen LA, Narasimhan M, Berger JS, et al. Mechanical complications of central venous catheters. J Intensive Care Med. 2006;21:40–6.CrossRefPubMed
12.
Hall AP, Russell WC. Toward safer central venous access: ultrasound guidance and sound advice. Anaesthesia. 2005;60:1–4.CrossRefPubMed
13.
Yonei A, Nonoue T, Sari A. Real-time ultrasonic guidance for percutaneous puncture of the internal jugular vein. Anesthesiology. 1986;64:830–1.CrossRefPubMed
14.
Jaques PF, Mauro MA, Keefe B. US guidance for vascular access. Technical note. J Vasc Interv Radiol. 1992;3:427–30.CrossRefPubMed
15.
16.
Miller AH, Roth BA, Mills TJ, et al. Ultrasound guidance versus the landmark technique for the placement of central venous catheters in the emergency department. Acad Emerg Med. 2002;9:800–5.CrossRefPubMed
17.
Leung J, Duffy M, Finckh A. Real-time ultrasonographically-guided internal jugular vein catheterization in the emergency department increases success rates and reduces complications: a randomized, prospective study. Ann Emerg Med. 2006;48:540–7.CrossRefPubMed
18.
Au AK, Rotte MJ, Grzybowski RJ, et al. Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters. Am J Emerg Med. 2012;30:1950–4.CrossRefPubMed
19.
Bruzoni M, Slater BJ, Wall J, et al. A prospective randomized trial of ultrasound- vs. landmark-guided central venous access in the pediatric population. J Am Coll Surg. 2013;216:939–43.CrossRefPubMed
20.
Steinberg C, Weinstock DJ, Gold JP, et al. Measurements of central blood vessels in infants and children: normal values. Catheter Cardiovasc Diagn. 1992;27:197–201.CrossRef
21.
Hughes P, Scott C, Bodenham A. Ultrasonography of the femoral vessels in the groin: implications for vascular access. Anaesthesia. 2000;55:1198–202.CrossRefPubMed
22.
Eksioglu AS, Tasci Yildiz Y, Senel S. Normal sizes of internal jugular veins in children/adolescents aged birth to 18 years at rest and during the valsalva maneuver. Eur J Radiol. 2014;83:673–9.CrossRefPubMed
23.
Breschan C, Platzer M, Jost R, et al. Size of internal jugular vs. subclavian vein in small infants: an observational, anatomical evaluation with ultrasound. Br J Anaesth. 2010;105:179–84.CrossRefPubMed
24.
Akingbola OA, Nielsen J, Hopkins RL, Frieberg EM. Femoral vein size in newborns and infants: preliminary investigation. Crit Care Lond Engl. 2000;4:120–3.CrossRef
25.
Mosteller RD. Simplified calculation of body-surface area. N Engl J Med. 1987;317:1098.PubMed
26.
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.CrossRef
27.
Iwashima S, Ishikawa T, Ohzeki T. Ultrasound-guided versus landmark-guided femoral vein access in pediatric cardiac catheterization. Pediatr Cardiol. 2008;29:339–42.CrossRefPubMed
28.
Stone MB, Moon C, Sutijono D, et al. Needle tip visualization during ultrasound-guided vascular access: short-axis vs. long-axis approach. Am J Emerg Med. 2010;28:343–7.CrossRefPubMed
29.
Pittiruti M, Hamilton H, Biffi R, et al. ESPEN guidelines on parenteral nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clin Nutr Edinb Scotl. 2009;28:365–77.CrossRef
30.
31.
Suk EH, Lee K-Y, Kweon TD, et al. Ultrasonographic evaluation of the femoral vein in anaesthetised infants and young children. Anaesthesia. 2010;65:895–8.CrossRefPubMed
32.
Sayin MM, Mercan A, Koner O, et al. Internal jugular vein diameter in pediatric patients: are the J-shaped guidewire diameters bigger than internal jugular vein? An evaluation with ultrasound. Paediatr Anaesth. 2008;18:745–51.CrossRefPubMed
33.
Yildirim I, Yüksel M, Okur N, et al. The sizes of internal jugular veins in Turkish children aged between 7 and 12 years. Int J Pediatr Otorhinolaryngol. 2004;68:1059–62.CrossRefPubMed
34.
Karazincir S, Akoğlu E, Balci A, et al. Dimensions of internal jugular veins in Turkish children aged between 0 and 6 years in resting state and during valsalva maneuver. Int J Pediatr Otorhinolaryngol. 2007;71:1247–50.CrossRefPubMed
35.
Troianos CA, Kuwik RJ, Pasqual JR, et al. Internal jugular vein and carotid artery anatomic relation as determined by ultrasonography. Anesthesiology. 1996;85:43–8.CrossRefPubMed
Metadata
Title
Vascular ultrasound in pediatrics: utility and application of location and measurement of jugular and femoral vessels
Authors
J. M. López Álvarez
O. Pérez Quevedo
L. Santana Cabrera
C. Rodríguez Escot
T. Ramírez Lorenzo
J. M. Limiñana Cañal
J. F. Loro Ferrer
Publication date
01-07-2018
Publisher
Springer Singapore
Published in
Journal of Medical Ultrasonics / Issue 3/2018
Print ISSN: 1346-4523
Electronic ISSN: 1613-2254
DOI
https://doi.org/10.1007/s10396-017-0853-y

Other articles of this Issue 3/2018

Journal of Medical Ultrasonics 3/2018 Go to the issue

Case Report

Left ventricular cardiac hemangioma in a patient with chronic heart failure

Case Report

Bladder cancer in an inguinal vesical hernia

Case Report

An experience of second-trimester anhydramnios salvaged by single amnioinfusion

Editorial

Present status and future of ultrasonic quantitative diagnostic techniques

Case Report

Superb microvascular imaging (SMI) findings of splenic artery pseudoaneurysm: a report of two cases

Case Report

Prolapsed bladder following rupture of patent urachal cyst, mimicking bladder exstrophy: a case report and literature review