Long-Axis In-Plane Approach Versus Short-Axis Out-of-Plane Approach for Ultrasound-Guided Central Venous Catheterization in Pediatric Patients: A Randomized Controlled Trial*
| Autor: | Ai Fujiwara, Nobuaki Shime, Hideki Matsuura, Hirofumi Hamaba, Kazuya Tachibana, Gaku Nagai, Tomonori Yamashita, Jun Takeshita, Yasufumi Nakajima |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Catheterization
Central Venous medicine.medical_specialty Short axis Venous catheterization Critical Care and Intensive Care Medicine law.invention Out of plane 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law 030225 pediatrics medicine Humans Prospective Studies Child Internal jugular vein Ultrasonography Interventional Ultrasonography business.industry 030208 emergency & critical care medicine Ultrasound guided Surgery In plane Child Preschool Relative risk Pediatrics Perinatology and Child Health Female Jugular Veins business |
| Zdroj: | Pediatric Critical Care Medicine. 21:e996-e1001 |
| ISSN: | 1529-7535 |
| Popis: | Objectives The aim of this study was to compare the occurrence of posterior wall puncture between the long-axis in-plane and the short-axis out-of-plane approaches in a randomized controlled trial of pediatric patients who underwent cardiovascular surgery under general anesthesia. Design Prospective randomized controlled trial. Setting Operating room of Osaka Women's and Children's Hospital. Patients Pediatric patients less than 5 years old who underwent cardiovascular surgery. Interventions Ultrasound-guided central venous catheterization using the long-axis in-plane approach and short-axis out-of-plane approach. Measurements and main results The occurrence of posterior wall puncture was compared between the long-axis in-plane and short-axis out-of-plane approaches for ultrasound-guided central venous catheterization. Patients were randomly allocated to a long-axis group or a short-axis group and underwent ultrasound-guided central venous catheterization in the internal jugular vein using either the long-axis in-plane approach (long-axis group) or the short-axis out-of-plane approach (short-axis group). After exclusion, 97 patients were allocated to the long-axis (n = 49) or short-axis (n = 48) groups. Posterior wall puncture rates were 8.2% (4/49) and 39.6% (19/48) in the long-axis and short-axis groups, respectively (relative risk, 0.21; 95% CI, 0.076-0.56; p = 0.0003). First attempt success rates were 67.3% (33/49) and 64.6% (31/48) in the long-axis and short-axis groups, respectively (relative risk, 1.04; 95% CI, 0.78-1.39; p = 0.77). Overall success rates within 20 minutes were 93.9% (46/49) and 93.8% (45/48) in the long-axis and short-axis groups, respectively (relative risk, 0.99; 95% CI, 0.90-1.11; p = 0.98). Conclusions The long-axis in-plane approach for ultrasound-guided central venous catheterization is a useful technique for avoiding posterior wall puncture in pediatric patients, compared with the short-axis out-of-plane approach. |
| Databáze: | OpenAIRE |
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