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Ultrasound-guided central venous cannulation in infants and children
1Department of Anesthesia and Intensive Care, Trondheim University Hospital, Trondheim, Norway. tilper@online.no
Insights
Ultrasound guidance for central venous catheter placement in pediatric patients is effective and safe. This method demonstrated high success rates and no complications, improving procedural precision in infants and children.
Area of Science:
- Pediatric Anesthesiology
- Vascular Access Procedures
- Medical Imaging in Pediatrics
Background:
- Central venous catheterization in infants and children presents unique challenges.
- Traditional landmark techniques for percutaneous central venous cannulation have limitations.
- Ultrasound-guided techniques offer a potential improvement for pediatric vascular access.
Purpose of the Study:
- To evaluate the ease of use, success rate, and complication profile of ultrasound-guided central venous catheter placement in pediatric patients.
- To compare the efficacy of ultrasound guidance versus traditional methods in infants and children.
- To assess the impact of ultrasound on the precision and safety of central venous cannulation in pediatric populations.
Main Methods:
- A prospective study involving 42 infants and children undergoing central venous catheter placement.
- Utilized an ultrasound scanner specifically designed for vascular puncture guidance.
- Employed a sterile technique with an accompanying kit for vessel puncture after ultrasound localization.
Main Results:
- Achieved successful central venous cannulation in all 42 pediatric patients.
- Reported zero complications during the catheter insertion procedures.
- Demonstrated a 95% first-attempt success rate for puncturing the right internal jugular vein, with a median cannulation time of 12 seconds.
Conclusions:
- Ultrasound-guided central venous catheter placement is readily applicable and user-friendly in infants and children.
- The technique appears to enhance the precision and safety of central venous catheterization in this vulnerable patient group.
- This method represents a significant advancement in pediatric vascular access procedures.
Background:
Percutaneous central venous cannulation in infants and children is a challenging procedure. Traditionally, an external landmark technique has been used to identify puncture site. An ultrasound-guided technique is now available and we wanted to evaluate this method in children and infants, looking specifically at the ease of use, success rate and complications.
Methods:
Forty-two consecutive infants and children (median 16.5 [0-177] months and 10 [3-45] kg) scheduled for central venous catheter placement were registered. An ultrasound scanner made for guiding puncture of vessels was used. After locating the puncture site, a sterile procedure was performed using an accompanying kit to aid puncture of the vessel.
Results:
Cannulation was successful in all patients and we had no complications during insertion of the catheters. The right internal jugular vein was preferred in most patients, and in 95% of the patients the vein was punctured at the first attempt. The median time from start of puncture to aspiration of blood was 12 (3-180) seconds.
Conclusion:
The ultrasound-guided technique for placement of central venous catheters was easy to apply in infants and children. It is our impression that it increased the precision and safety of the procedure in this group of patients.