Resumen

GOMEZ DANIES, Hernando; REYES PATINO, Darío  y  SANCHEZ HERRERA, Paola. Precisión diagnóstica de diferentes técnicas para hallar la vena yugular interna en niños de 6 meses a 16 años . Rev. colomb. anestesiol. [online]. 2007, vol.35, n.1, pp.37-43. ISSN 0120-3347.

Objective. To describe the transmuscular approach modified by Reyes (TMMR) and compare the effectiveness and safety of four techniques including anterior, medium, palpatory and TMMR. Methods. Observational prospective cohort study. In 32 pediatric patients, with no cervical pathology that went to the radiology department or where hospitalized in the pediatric ward or ICU at Fundación Hospital de la Misericordia (HOMI) a comparison of the effectiveness to locate the IJV, between the techniques described was made using ultrasound as the gold standard. Safety was also compared by studying the distance between the point of puncture each technique predicted and the border of the carotid artery (distance pbc). Results. The effectiveness rates for the 4 techniques where 96,9%, 90,3%, 93,8% y 93,8% for anterior, medium, palpatory and TMMR respectively. The distance between the predicted puncture site and the center or the IJV was shorter for the palpatory and transmuscular approaches with mean distance of 1,78 y 1,98 mm respectively (95%CI 1,2 - 2,35 y 1,32 - 2,64), compared with anterior and medium approaches, with 2,65 y 2,78 mm respectively (95%CI 2,01 - 3,29 y 1,91 - 3,65). The comparison of pbc distance and the distance between the skin and the IJV yielded no significant differences. Conclusions. In pediatric population, TMMR and palpatory techniques are as safe as the other approaches,and as or even more effective than the anterior and medium approach. These results suggest that the 4 techniques are equally safe concerning the most frequent complication, which is arterial puncture.

Palabras clave : Catheter; jugular; thecniques; ultrasonography.

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