Vascular access in children

Area of Science:

• Pediatric Anesthesiology
• Vascular Access Techniques

Background:

• Vascular access is a critical skill for anesthesiologists, often challenging in pediatric patients due to various medical conditions.
• Difficult vascular access in children requires specialized techniques and tools for successful outcomes.

Purpose of the Study:

• To review various pediatric vascular access routes, techniques, and complications.
• To provide guidance on indications, site selection, and securing methods for pediatric vascular access.

Main Methods:

• Comprehensive literature search in PubMed, Embase, and Google Scholar using keywords like 'pediatric,' 'vascular access,' 'venous access,' and 'techniques' or 'complications.'
• Screening of English language articles to include relevant content on pediatric vascular access.

Main Results:

• Intraosseous access is a rapid, life-saving technique, even in hypovolemic pediatric patients.
• Transillumination, near-infrared light, and ultrasonography enhance vein visualization and guide catheter placement, reducing complications.
• Fluoroscopy is valuable for long-term vascular access device insertion.

Conclusions:

• Ultrasonography is the standard of care for pediatric vascular access, improving vessel selection and complication prevention.
• Various techniques, including intraosseous, transillumination, and ultrasonography, offer solutions for challenging pediatric vascular access.
• This review synthesizes information on pediatric vascular access routes, techniques, and complications for clinical application.