Original Article

Cephalic Jugular Venous Blood Gas Measurement during Neonatal Venoarterial Extracorporeal Membrane Oxygenation

¹ Department of Neonatology, The Children's Mercy Hospital and University of Missouri- Kansas City School of Medicine, Kansas City, Missouri.
² Department of Surgery, The Children's Mercy Hospital and University of Missouri- Kansas City School of Medicine, Kansas City, Missouri.
³ St. Luke's Perinatal Center, Section of Perinatal Pediatrics, Kansas City, Missouri.

^* Address correspondence to: Timothy A O'Connor, MD Department of Child Health One Hospital Drive Columbia, MO 65212

Abstract

Cannulation of the cephalic portion of the right internal jugular vein during extracorporeal membrane oxygenation (ECMO) allows for increased venous return flow to the circuit.

This procedure also allows access to venous drainage from the brain. We reviewed data from simultaneous blood gases obtained from the cephalic jugular vein and the mixed venous return in 5 neonates during venoarterial ECMO. Cephalic venous pO₂ values were significantly lower than mixed venous pO₂ values (P < .001). The values for pH and pCO₂ did not vary between the sites. Our experience with 34 infants using cephalic jugular drainage is reviewed. Since the institution of right jugular venous drainage, the intracranial hemorrhage rate in neonates undergoing ECMO at our center has decreased from 34% to 6% (p < .01).