Optimal insertion depth of subclavian vein catheterization via the right supraclavicular approach in children

Tan, Yanzhe; Shi, Shujun; Liu, Lifei

doi:10.1111/pan.14107

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…Limited studies exist that describe a body height or landmark‐based calculation of access to the LBCV 4,17 . In our study, it was remarkable that there was no significant difference in the tip position between the two different approaches.…”

Section: Discussionmentioning

confidence: 63%

“…Limited studies exist that describe a body height or landmarkbased calculation of access to the LBCV. 4,17 In our study, it was remarkable that there was no significant difference in the tip position between the two different approaches. The distance from the carina was 5.38 ± 13.6 mm in the RIJV group and 4.94 ± 15.1 mm in the LBCV group respectively (p = .541).…”

Section: Deep Vein Thrombosis Is a Serious Complication In Neonatesmentioning

confidence: 56%

“…There are several formulas for predicting the correct depth of CVC insertion in children 4,15–17 . The distance from the skin puncture site to the junction of the superior vena cava to the right atrium was calculated using a formula based on body height.…”

Section: Methodsmentioning

confidence: 99%

“…There are several formulas for predicting the correct depth of CVC insertion in children. 4,[15][16][17] The distance from the skin puncture site to the junction of the superior vena cava to the right atrium was calculated using a formula based on body height. Optimal depth of insertion at skin level was calculated in (cm) according to the equation Body height (cm)/10 + 1.…”

Section: Placement Of the Cvcmentioning

confidence: 99%

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Ultrasound‐guided supraclavicular cannulation of left brachiocephalic versus right internal jugular vein: Comparative analysis of central venous catheter‐associated complications

Falay

Schindler

Mikus

et al. 2022

Pediatric Anesthesia

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Aims Central venous catheters are essential for the management of pediatric cardiac surgery patients. Recently, an ultrasound‐guided access via a supraclavicular approach to the brachiocephalic vein has been described. Central venous catheters are associated with a relevant number of complications in pediatric patients. In this study, we evaluated the frequency of complications of left brachiocephalic vein access compared with right internal jugular vein standard access in children undergoing cardiac surgery. Methods Retrospective analysis of all pediatric cases at our tertiary care university hospital over a two‐year period receiving central venous catheters for cardiac surgery. Primary endpoint: Frequency of complications associated with central venous catheters inserted via the left brachiocephalic vein vs. right internal jugular vein. Complications were defined as: chylothorax, deep vein thrombosis, sepsis, or delayed chest closure. Secondary endpoints: Evaluation of the insertion depth of the catheter using a height‐based formula without adjustment for side used. Results Initially, 504 placed catheters were identified. Following inclusion and exclusion criteria, 480 placed catheters remained for final analysis. Overall complications were reported in 68/480 (14.2%) cases. There was no difference in the frequency of all complications in the left brachiocephalic vein vs. the right internal jugular vein group (15.49% vs. 13.65%; OR = 1.16 [0.64; 2.07]), nor was there any difference considering the most relevant complications chylothorax (7.7% vs. 8.6%; OR = 0.89 [0.39; 1.91]) and thrombosis (5.6% vs. 4.5%; OR = 1.28 [0.46; 3.31]). The mean deviation from the optimal insertion depth was left brachiocephalic vein vs. right internal jugular vein 5.38 ± 13.6 mm and 4.94 ± 15.1 mm, respectively. Conclusions Among children undergoing cardiac surgery, there is no significant difference between the supraclavicular approach to the left brachiocephalic vein and the right internal jugular vein regarding complications. For both approaches, a universal formula can be used to determine the correct insertion depth.

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Section: Discussionmentioning

confidence: 63%

Section: Deep Vein Thrombosis Is a Serious Complication In Neonatesmentioning

confidence: 56%

Section: Methodsmentioning

confidence: 99%

Section: Placement Of the Cvcmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound‐guided supraclavicular cannulation of left brachiocephalic versus right internal jugular vein: Comparative analysis of central venous catheter‐associated complications

Falay

Schindler

Mikus

et al. 2022

Pediatric Anesthesia

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A simple calculation formula for the insertion depth of catheter of the central venous access port in Chinese patients

Chen,

Xie,

Wang

et al. 2024

Heliyon

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Right subclavian vein sonoanatomy from the supraclavicular fossa approach in children

Giraldo Gutiérrez,

Bolívar Trujillo,

Velásquez Granados

et al. 2024

Colomb. J. Anesthesiol.

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Introduction: Although the subclavian vein offers significant advantages over other approaches for ultrasound-guided central venous access, it is not the first choice in the pediatric population, mainly due to its proximity to the pleura and the subclavian artery. Objective: To assess the sonoanatomical characteristics of the subclavian vein and adjacent structures using the supraclavicular approach in a pediatric population. Materials and Methods: Observational, intraoperative, cross-sectional study, between June 2021 and March 2022. The population consisted of ASA I, II and III children taken to non-emergent surgical procedures under general anesthesia. Images were acquired with the patients under general anesthesia, using a high-frequency linear probe to identify the subclavian vein and measure the anatomical landmarks. Results: A total of 67 children were recruited; mean age was 6 years (IQR: 2-12 years), with male sex predominance (61%). Median weight was 22 kg (IQR: 12.2-34 Kg) and median height was 115 cm (IQR: 88-142 cm). Measurements in relation to the vessel showed a mean distance from the skin of 0.70 cm (SD: 0.18 cm), while mean distance from the skin to the pleura was 1.31 cm (SD: 0.28 cm). Mean vein diameter was 0.49 cm (IQR: 0.40-0.63 cm). The mean hypothetical approach angle to the vessel was 22.09 degrees (SD: 4.37 degrees), while the approach angle to the pleura was 39 degrees (SD: 5.31 degrees). No concurrent visualization of the vein and artery was documented in any of the recorded sonoanatomy windows. The tests pointed to an average difference of 0.61 cm in vessel depth in relation to the pleura, and the angle of approach to the vessel was 16.91 degrees smaller when compared with the angle of approach to the pleura (p < 0.001). Conclusions: Using this technique, the supraclavicular approach to the subclavian vein in children is safe and feasible, with an average skin-to-vessel distance of 0.70 cm, minimizing the risk of pleural puncture. Additional studies are required to optimize this technique in the pediatric population.

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Optimal insertion depth of subclavian vein catheterization via the right supraclavicular approach in children

Cited by 3 publications

References 19 publications

Ultrasound‐guided supraclavicular cannulation of left brachiocephalic versus right internal jugular vein: Comparative analysis of central venous catheter‐associated complications

Ultrasound‐guided supraclavicular cannulation of left brachiocephalic versus right internal jugular vein: Comparative analysis of central venous catheter‐associated complications

A simple calculation formula for the insertion depth of catheter of the central venous access port in Chinese patients

Right subclavian vein sonoanatomy from the supraclavicular fossa approach in children

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