Left Internal Jugular Vein in Neonates

In addition to the complex trajectory of the left internal jugular vein (LIJV), the small neck size in neonates presents a significant challenge. Therefore, the application of the dynamic needle tip positioning technique (DNTP) guided by ultrasound, observed through the short-axis view (SAX view), emerges as an essential tactic to mitigate complications. I illustrate the puncture method using an intravenous catheter, where DNTP ensures the accuracy of insertion in real time and reduces the risk of inadvertently damaging adjacent structures. At this early stage of the patient’s life, it is even more critical to insert the catheter tube into the vein, as during Seldinger’s technique, special care must be taken to manipulate the guide to ensure its arrival at the superior vena cava and prevent accidental displacement of the catheter tube.