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Comparative Study of Complications in CV Catheter Insertion for Pediatric Patients: Real-time Ultrasound-guided

Shuichi Takano1, Norio Shimizu1, Naruo Tokuyasu1

  • 1Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.

Yonago Acta Medica
|February 14, 2018
PubMed

Insights

Real-time ultrasound-guided puncture (RTUS) for pediatric central venous catheters (CVC) insertion shows fewer mechanical complications than venography-guided puncture (VG). Delayed complications and premature removal are more common in children under five years old.

Area of Science:

  • Pediatric Surgery
  • Vascular Access
  • Interventional Radiology

Background:

  • Tunneled central venous catheters (CVC), such as Broviac/Hickman catheters, are crucial for long-term pediatric treatment.
  • Percutaneous CVC insertion is increasingly favored for its minimally invasive nature.
  • Understanding complications associated with different CVC insertion techniques is vital for patient safety.

Purpose of the Study:

  • To review mechanical and delayed complications of CVC insertion in pediatric patients.
  • To compare complication rates among surgical cut-down (CD), real-time ultrasound-guided puncture (RTUS), and venography-guided puncture (VG) insertion methods.
  • To identify risk factors associated with CVC insertion complications in this population.

Main Methods:

  • A retrospective review of 159 pediatric patients undergoing CVC insertion.
  • Procedures included surgical venous cut-down (CD), real-time ultrasound-guided puncture (RTUS), and venography-guided puncture (VG).
  • Analysis of mechanical and delayed complications, stratified by insertion technique and patient age.

Main Results:

  • No mechanical complications were observed with CD or RTUS, while 3 (6%) occurred with VG.
  • Delayed complications and premature removal were significantly higher in patients under 5 years old (42% overall).
  • No significant risk factors for mechanical complications were identified.

Conclusions:

  • Real-time ultrasound-guided puncture (RTUS) is associated with fewer mechanical complications compared to venography-guided puncture (VG).
  • Pediatric patients under 5 years old are at higher risk for delayed complications and premature CVC removal.
  • RTUS should be considered for CVC insertion to minimize mechanical complications in pediatric patients.
Abstract

Keywords:
central venous catheterchildrenpediatric interventionreal-time ultrasound guidevenography guide

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