External jugular vein cannulation – A double-edged sword

Ahmad, Suma Rabab; Bellapukonda, Snigdha; Mohanty, Chitta Ranjan; Tapuria, Priyank

doi:10.4103/ija.ija_672_20

Cited by 8 publications

References 7 publications

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Improving advanced intraoperative MRI methods during pediatric neurosurgery

Jellema,

Mannsdörfer,

Visser

et al. 2024

NMR in Biomedicine

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Advanced intraoperative MR images (ioMRI) acquired during the resection of pediatric brain tumors could offer additional physiological information to preserve healthy tissue. With this work, we aimed to develop a protocol for ioMRI with increased sensitivity for arterial spin labeling (ASL) and diffusion MRI (dMRI), optimized for patient positioning regularly used in the pediatric neurosurgery setting. For ethical reasons, ASL images were acquired in healthy adult subjects that were imaged in the prone and supine position. After this, the ASL cerebral blood flow (CBF) was quantified and compared between both positions. To evaluate the impact of the RF coils setups on image quality, we compared different setups (two vs. four RF coils) by looking at T1‐weighted (T1w) signal‐to‐noise ratio (SNR) and contrast‐to‐noise ratio (CNR), as well as undertaking a qualitative evaluation of T1w, T2w, ASL, and dMR images. Mean ASL CBF did not differ between the surgical prone and supine positions in any of the investigated regions of interest or the whole brain. T1w SNR (gray matter: p = 0.016, 34% increase; white matter: p = 0.016, 32% increase) and CNR were higher (p = 0.016) in the four versus two RF coils setups (18.0 ± 1.8 vs. 13.9 ± 1.8). Qualitative evaluation of T1w, T2w, ASL, and dMR images resulted in acceptable to good image quality and did not differ statistically significantly between setups. Only the nonweighted diffusion image maps and corticospinal tract reconstructions yielded higher image quality and reduced susceptibility artifacts with four RF coils. Advanced ioMRI metrics were more precise with four RF coils as the standard deviation decreased. Taken together, we have investigated the practical use of advanced ioMRI during pediatric neurosurgery. We conclude that ASL CBF quantification in the surgical prone position is valid and that ASL and dMRI acquisition with two RF coils can be performed adequately for clinical use. With four versus two RF coils, the SNR of the images increases, and the sensitivity to artifacts reduces.

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Improving advanced intraoperative MRI methods during pediatric neurosurgery

Jellema,

Mannsdörfer,

Visser

et al. 2024

NMR in Biomedicine

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Placement of a Sterile Ultrasound Guided Peripheral Intravenous Catheter in a Pediatric Patient with Severe Respiratory Distress as a Bridge to Wire Exchange for Central Venous Access

Ostroff

Connolly

2022

Ultrasound Guided Vascular Access

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Vascular access modalities in a pediatric intensive care unit in tertiary hospital indications and outcomes: a single-center cross-sectional study

Aziz,

Bazaraa,

Aboulmakarem

et al. 2023

Egypt Pediatric Association Gaz

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Background Vascular access is a mainstay of pediatric critical care. The selection of the route of access and equipment used will depend on patient- and provider-specific factors, which constantly need revision to achieve more effective assessment and management. Objective To evaluate the use, indication, and outcome of different vascular access modalities in critically ill children in the Emergency Pediatric Intensive Care Unit (ER-PICU) of a tertiary university hospital. Patients and methods This cross-sectional descriptive study was based on data collected by reviewing all modes of vascular access used for 168 consecutive patients admitted to ER-PICU during a 6-month period from May to October 2020. Results Among the study group (n = 168), there were 92 males (54.8%) and 76 females (45.2%). The median age of cases was 18 months. 333 vascular access devices were observed: 219 peripheral (65.8%) and 114 central catheters (34.2%). Catheters lasted a total of 1920 catheter days. Central venous catheters lasted significantly more than peripheral lines (P < 0.001); median of 8.5 and 3 days, respectively. The incidence of peripheral line complications (35.2%) was found significantly higher compared to central venous catheters (22.8%) (P. = 0.021). Longer dwell time of central access was associated with a higher incidence of catheter-related bloodstream infection. The incidence of catheter-related bloodstream infection was 9.05 per 1000 catheter days. Mortality rate was 24.4%. Conclusions Despite having lower incidence of complications than peripheral lines, central venous catheters’ complications are considered more serious. Dwell time of central venous catheters (CVC) should be revised daily to avoid the occurrence of infection.

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External jugular vein cannulation – A double-edged sword

Cited by 8 publications

References 7 publications

Improving advanced intraoperative MRI methods during pediatric neurosurgery

Improving advanced intraoperative MRI methods during pediatric neurosurgery

Placement of a Sterile Ultrasound Guided Peripheral Intravenous Catheter in a Pediatric Patient with Severe Respiratory Distress as a Bridge to Wire Exchange for Central Venous Access

Vascular access modalities in a pediatric intensive care unit in tertiary hospital indications and outcomes: a single-center cross-sectional study

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