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Open Versus Ultrasound Guided Tunneled Central Venous Access in children: A Randomized Controlled Study
Soundappan S V Soundappan1, Lawrence Lam2, Daniel T Cass1
1Department of Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Division of Child and Adolescent health, Sydney Medical School, University of Sydney, NSW, Australia.
The Journal of Surgical Research
|December 28, 2020
Summary
Ultrasound-guided percutaneous insertion of central venous catheters is safe and effective in pediatric patients. This method reduces operating time and preserves vein size without increasing complication rates compared to open insertion.
Area of Science:
- Pediatric Surgery
- Medical Devices
- Interventional Radiology
Background:
- Central venous catheter insertion is a common procedure in pediatric care.
- Complication rates and procedural efficiency are key concerns for central venous access.
Purpose of the Study:
- To compare the safety and complication rates of open insertion versus ultrasound-guided percutaneous insertion of central venous catheters in children.
- To evaluate procedural efficiency and outcomes associated with each insertion method.
Main Methods:
- Prospective randomized trial involving pediatric patients under 16 years of age.
- Procedures performed by surgeons with varied experience levels.
- Primary outcome: immediate and late complications; Secondary outcomes: procedure time, conversion rates, line duration.
Main Results:
- No conversions to open procedure in the ultrasound group; 22% of cases required more than one puncture.
- Operating time was 20.6% shorter with percutaneous access.
- Significant decrease in vein size observed in the open insertion group post-removal.
Conclusions:
- Ultrasound-guided percutaneous insertion is a safe and effective technique for pediatric central venous catheter placement.
- This method offers reduced operating times and preserves vein size without increasing complication rates, even with varying operator expertise.
