Comparison of ultrasound guided brachiocephalic and internal jugular vein cannulation in critically ill children
Autor: | Antonio Rodríguez-Núñez, Ana Muñoz-Lozón, Ignacio Oulego-Erroz, Paula Alonso-Quintela |
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Rok vydání: | 2016 |
Předmět: |
Male
Catheterization Central Venous medicine.medical_specialty Adolescent Critical Illness Sedation medicine.medical_treatment Pilot Projects Intensive Care Units Pediatric Critical Care and Intensive Care Medicine Pediatrics law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law medicine Humans Anesthesia Prospective Studies Child Internal jugular vein Ultrasonography Interventional Brachiocephalic vein Brachiocephalic Veins Mechanical ventilation Pediatric intensive care unit business.industry Critically ill Infant Newborn Infant 030208 emergency & critical care medicine Surgery Child Preschool Female Jugular Veins medicine.symptom business Central venous catheter |
Zdroj: | Journal of Critical Care. 35:133-137 |
ISSN: | 0883-9441 |
Popis: | To determine whether ultrasound (US)-guided longitudinal in-plane supraclavicular cannulation of the brachiocephalic vein (BCV) improves cannulation success rates compared to transverse out-of-plane internal jugular vein (IJV) cannulation in urgent insertion of temporary central venous catheters (CVC) in critically ill children.Prospective open pilot (non-randomized) comparative study carried out in a pediatric intensive care unit (PICU) of a university-affiliated hospital. Newborns and children aged 0 to 14 years admitted to the PICU in whom an urgent CVC was clinically indicated and was inserted in the IJV or BCV by US guidance were eligible. First-attempt success rate, overall success rate, number of puncture attempts, and cannulation time were compared between IJV and BCV techniques.Forty-six procedures (24 IJV and 22 BCV) in 38 patients were included. Full-sample median (range) age and weight were 13 (0.6-160) months and 9.5 (0.94-50) kg. No significant differences between IJV and BCV groups were observed for sex, age, weight, admission diagnosis, intra-procedural mechanical ventilation and sedation protocol. First attempt success rate was higher in the BCV than the IJV group (73 vs 37.5%, P= .017). Overall success rate was slightly higher in the BCV group (95 vs 83%, P = nonsignificant). Median (range) number of cannulation attempts [1 (1-3) vs 2 (1-4)] and cannulation time [66 (25-300) vs 170 (40-500) seconds] were significantly lower in the BCV group (P.05). Patient's weight was inversely related to the number of cannulation attempts (Pearson coefficient -0.537, P= .007) and cannulation time (Pearson coefficient -0.495, P= .014) in the IJV but not in the BCV group. No major complications were observed.Ultrasound-guided supraclavicular in-plane BCV cannulation improved first attempt CVC cannulation success rates and reduced puncture attempts and cannulation time compared to US-guided out-of-plane IJV in critically ill children. A large randomized clinical trial is warranted to confirm our results. |
Databáze: | OpenAIRE |
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