Comparison of internal and external jugular cannulation of the central circulation in the pediatric patient

Percutaneous catheterization of the central circulation via the internal jugular vein was compared to cannulation via the external jugular vein, in a retrospective review of 200 pediatric patients. The internal approach resulted in an 86% rate of successful cannulations with 99.9% of the catheters positioned in the thorax; this technique was accompanied by an 8% incidence of carotid artery puncture. The external jugular route eliminated the risk of carotid artery puncture; however, it was successful in only 65% of the attempts, and 14% of the successful cannulations had catheter tips incorrectly positioned outside the thorax.