Shifting from open surgical cut down to ultrasound-guided percutaneous central venous catheterization in children: learning curve and related complications

Autor: Giuseppe Fratino, Girolamo Mattioli, Angelo Claudio Molinari, Edoardo Lanino, F. Faranda, Elio Castagnola, Alberto Michelazzi, Leila Mameli, V. Jasonni, Claudio Granata, Piero Buffa, Stefano Avanzini, Massimo Conte, Edoardo Guida, Alessio Pini-Prato
Rok vydání: 2010
Předmět:
Male
Catheterization
Central Venous
medicine.medical_specialty
Catheters
Percutaneous
Adolescent
Venous catheterization
Single Center
Catheterization
methods
Catheters
Indwelling
Postoperative Complications
Central Venous
Pediatric surgery
Humans
Medicine
education/methods
Preschool
Child
Ultrasonography
Interventional
Ultrasonography
Interventional
business.industry
Ultrasound
Infant
Newborn
Infant
General Medicine
Newborn
Ultrasound guided
Surgery
Treatment Outcome
Parenteral nutrition
Indwelling
Italy
Child
Preschool
Pediatrics
Perinatology and Child Health
Adolescent
Catheterization
methods
Catheters
Indwelling
Child
Child
Preschool
Clinical Competence
Female
Humans
Infant
Infant
Newborn
Italy
epidemiology
Male
Postoperative Complications
epidemiology
Treatment Outcome
Ultrasonography
Interventional
Vascular Surgical Procedures
epidemiology
Female
Clinical Competence
business
Complication
Vascular Surgical Procedures
Zdroj: Pediatric Surgery International. 26:819-824
ISSN: 1437-9813
0179-0358
DOI: 10.1007/s00383-010-2636-z
Popis: Tunneled indwelling central venous catheters (CVC) are essential in the management of children with cancer, hematological, nephrological disorders and for parenteral nutrition. The aim of this study is to present the experience of a single center of the transition from traditional open surgical cut down procedure (OSC) to ultrasound (US)-guided percutaneous CVC insertion, focusing on learning curve and related complications. All CVCs inserted between April 2008 and November 2009 in children at the Gaslini Children Hospital were revised, and data on methods of cannulation, intraoperative and device-related complications and re-intervention were recorded. 194 CVCs were positioned in 188 patients. 128 out of 194 CVCs were positioned through an OSC technique, whereas the remaining 66 CVCs were inserted percutaneously with US guidance. Of the 27 recorded complications, 15 were mechanical events, 7 cases developed infection, whereas the remaining 5 (2.6%) were classified as intraoperative complications. A second surgical procedure was described in 23 (11.8%) cases. Shifting from OSC to US-guided percutaneous CVC insertion inevitably involves a challenging learning curve which is generally associated with high complication rates. Complications progressively decrease once a good experience in US guidance and percutaneous technique has been obtained.
Databáze: OpenAIRE
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