Randomized Comparison of Oblique versus Transverse Orientation for Ultrasound-Guided Internal Jugular Venous Cannulation in Pediatric Heart Surgery Patients

Background: Ultrasound-guided internal jugular venous access improves the rate of successful cannulation of the internal jugular vein in both adult and pediatric patients. Internal jugular venous cannulation in pediatric patients is anatomically and technically more challenging than in adults. The oblique method is a novel approach for guiding central venous cannulation. There is currently a scarcity of research on central venous cannulation techniques for pediatric patients. Aim: The purpose of this study was to compare the success rates between the oblique and transverse approach of jugular venous cannulation in pediatric cardiac surgery patients. Methods: A prospective randomized clinical trial of pediatric patients who underwent cardiac surgery at Cipto Mangunkusumo Hospital was conducted between February and May 2021. Sixty patients were randomized into two groups: 30 in the oblique group and 30 in the transverse group. Results: There was no difference in the first needle pass success rate between the oblique and transversal approaches (86.7% vs. 73.3%; P = 0.19). There is no difference in the total number of attempts between the two groups (1.3 vs 1.43; P > 0.05). Conclusion: There was no difference between oblique and transverse orientations for internal jugular venous cannulation in pediatric cardiac surgery patients in terms of successful cannulation on the first needle pass and total number of attempts.