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Jugular vs femoral vein for central venous catheterization in pediatric cardiac surgery (PRECiSE): study protocol for

Simona Silvetti1, Tommaso Aloisio2, Anna Cazzaniga2

  • 1Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy. lu.simo@hotmail.it.

Trials
|June 27, 2018
PubMed

Insights

This study compares central venous catheter (CVC) insertion sites in infants undergoing heart surgery. The jugular site is hypothesized to have fewer infectious complications like catheter-related bloodstream infections (CRBSIs) than the femoral site.

Area of Science:

  • Pediatric Cardiac Surgery
  • Vascular Access
  • Infectious Complications

Background:

  • Central venous catheters (CVCs) are critical for managing pediatric congenital heart disease patients.
  • Assessing infectious and mechanical complications associated with different CVC insertion sites is crucial in this population.

Purpose of the Study:

  • To evaluate infectious complications (catheter colonization, catheter line-associated bloodstream infections, CRBSIs) and mechanical complications.
  • To compare infectious risks between jugular and femoral vein central venous access sites in infants undergoing cardiac surgery.

Main Methods:

  • A randomized controlled trial (RCT) involving 160 infants under one year old scheduled for cardiac surgery.
  • Patients were randomly assigned to either jugular or femoral vein CVC insertion.
  • CVC insertion was performed by expert operators.

Main Results:

  • The study aims to determine if the jugular insertion site is associated with lower rates of catheter colonization and CRBSI compared to the femoral site.
  • Data on infectious and mechanical complications will be collected and analyzed.

Conclusions:

  • Evidence on the impact of CVC insertion site on infectious complications in pediatric patients is not conclusive.
  • This RCT hypothesizes that the jugular vein approach offers a lower risk of catheter colonization and CRBSI than the femoral vein approach in infants undergoing cardiac surgery.
Abstract

Keywords:
Catheter-related bloodstream infection (CRBSI)Central line–associated bloodstream infection (CLABSI)Congenital heart diseaseInfectionNewborn

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