Internal jugular vein deformities after central venous catheterisation in neonates: evaluation by Doppler ultrasound

Abstract

AIM: The use of a central venous catheter (CVC) through the internal jugular vein (IJV) in neonates is associated with various complications. We postulated that the risk of vein deformity after removing the CVC is underestimated. This study aimed to evaluate, using Doppler ultrasound, morphological changes in the IJV that had undergone CVC insertion during the neonatal period.

METHODS: The study consisted of 23 cases, in which 2.7 Fr Broviac (Bard Access Systems, Salt Lake City, Utah, USA) CVCs were inserted through the IJVs of newborns over a 2-year period. After the removal of the CVCs, the IJVs were examined by Doppler ultrasound.

RESULTS: Seventeen cases had normal appearances, but six (26%) cases had deformities. One case had a completely obstructed IJV, and five had abnormal compressibility, echogenic intravascular masses or monophasic waveforms of blood flow. On follow-up, IJV deformities were not improved but tended to be aggravated. There were significant differences in gestational age (36.6 +/- 3.2 weeks vs. 30.0 +/- 3.9 weeks, P= 0.002), body weight at time of CVC insertion (2.60 +/- 0.72 kg vs. 1.32 +/- 0.47 kg, P= 0.001) and duration of catheter use (25.9 +/- 13.6 days vs. 49.0 +/- 22.0 days, P= 0.016) between the normal and deformity groups, respectively.

CONCLUSIONS: IJV deformities after central venous catheterisation in neonates are common. A lower gestational age, a lower body weight, and more catheter indwelling days are significant factors affecting the incidence of IJV deformities.