Ultrasound-guided or landmark techniques for central venous catheter placement in critically ill children
| Autor: | Juan Mayordomo-Colunga, Patricia García-Soler, Ana Llorente-de-la-Fuente, Carmen Clavero-Rubio, Juan José Menéndez-Suso, Paula Santos-Herraiz, Antonio Rodríguez-Núñez, Mª Soledad Holanda-Peña, Ignacio Oulego-Erroz, Sira Fernández-De-Miguel, Recanva collaborative study, María Sánchez-Porras, Luis Renter-Valdovinos, Daniel Palanca-Arias, Rafael González-Cortes, Manuel Frías-Pérez, Mónica Balaguer-Gargallo |
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| Rok vydání: | 2017 |
| Předmět: |
Catheterization
Central Venous medicine.medical_specialty Adolescent Critical Illness medicine.medical_treatment Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Anesthesiology medicine Central Venous Catheters Humans Prospective Studies Child Prospective cohort study Vein Ultrasonography Interventional business.industry Ultrasound Infant Newborn Infant 030208 emergency & critical care medicine Odds ratio Confidence interval Surgery medicine.anatomical_structure Spain Child Preschool Propensity score matching business Central venous catheter |
| Zdroj: | Intensive Care Medicine. 44:61-72 |
| ISSN: | 1432-1238 0342-4642 |
| DOI: | 10.1007/s00134-017-4985-8 |
| Popis: | To assess whether ultrasound guidance improves central venous catheter placement outcomes compared to the landmark technique in critically ill children. A prospective multicentre observational study was carried out in 26 paediatric intensive care units over 6 months. Children 0–18 years old who received a temporary central venous catheter, inserted using either ultrasound or landmark techniques, were eligible. The primary outcome was the first-attempt success rate. Secondary outcomes included overall placement success, number of puncture attempts, number of procedures requiring multiple punctures (> 3 punctures), number of procedures requiring punctures at more than one vein site and immediate mechanical complications. To account for potential confounding factors, we used propensity scores. Our primary analysis was based on 1:1 propensity score matching. The association between cannulation technique and outcomes in the matched cohort was estimated using generalized estimating equations and mixed-effects models to account for patient-level and hospital-level confounders. Five hundred central venous catheter-placement procedures involving 354 patients were included. Ultrasound was used for 323 procedures, and the landmark technique was used for 177. Two hundred and sixty-six procedures were matched (133 in the ultrasound group and 133 in the landmark group). Ultrasound was associated with an increase in the first-attempt success rate [46.6 vs. 30%, odds ratio 2.09 (1.26–3.46); p |
| Databáze: | OpenAIRE |
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